Department of Ageing and Health, Guy's and St Thomas' NHS Foundation Trust, London, SE1 7EH, United Kingdom.
King's College London, London, WC2R 2LS, United Kingdom.
Age Ageing. 2023 Oct 2;52(10). doi: 10.1093/ageing/afad169.
Unpaid carers are an increasing proportion of the UK population. One of the many ways in which they help those they care for is assisting with medication adherence. Many older adults have medicines dispensed in pharmacy-filled multi-compartment medication compliance aids (pMCAs). However, evidence suggests that pMCAs may increase medication-related harm, and little is known about the interaction between the user, medication adherence systems and the carer.
To explore the views of carers supporting older adults to manage their medications with and without a pMCA.
A researcher-administered questionnaire survey of carers supporting older adults to manage their medicines with or without a pMCA. Participants were recruited from inpatient wards, outpatient clinics and community services in central London. Responses were analysed by two independent researchers to identify overarching themes.
Eighty-eight unpaid carers were interviewed and responses were categorised according to the medication adherence method used; 47 supported a user with a pMCA and 41 supported without a pMCA. The main themes were: Time, Responsibility and Mistakes, Waste and Sustainability, and Polypharmacy, with sub-themes of design of multi-compartment medication compliance aids, organisation and reassurance.
Supporting medication adherence puts considerable burden on carers regardless of whether a self- or pharmacy-filled medication compliance aid is used or not. Prescribers could alleviate this burden through regular medication review by considering the prescribing frequency and duration and medication rationalisation. Redesign of both pMCAs and systems surrounding their use could also help reduce carer's burden and environmental burden.
在英国，无偿照顾者的比例在不断增加。他们帮助照顾对象的方式之一是协助用药依从性。许多老年人的药物都是在药剂师配药的多剂量药物依从性辅助器具（pMCA）中分发的。然而，有证据表明 pMCA 可能会增加与药物相关的伤害，而且人们对用户、药物依从性系统和照顾者之间的相互作用知之甚少。
探讨照顾者在有无 pMCA 的情况下支持老年人管理其药物的观点。
对照顾者进行了一项研究者管理的问卷调查，这些照顾者支持老年人管理他们的药物，无论是否使用 pMCA。参与者是从伦敦市中心的住院病房、门诊诊所和社区服务中招募的。两名独立的研究人员对回复进行了分析，以确定总体主题。
对 88 名无偿照顾者进行了访谈，根据使用的药物依从性方法对回复进行了分类；47 名照顾者支持使用 pMCA 的使用者，41 名照顾者支持不使用 pMCA 的使用者。主要主题是：时间、责任和错误、浪费和可持续性以及多药治疗，还有多剂量药物依从性辅助器具的设计、组织和保证等子主题。
无论是否使用自行或药剂师配药的药物依从性辅助器具，支持药物依从性都会给照顾者带来相当大的负担。通过定期进行药物审查，考虑处方的频率和持续时间以及药物合理化，可以减轻这种负担。对 pMCA 和围绕其使用的系统进行重新设计也可以帮助减轻照顾者的负担和环境负担。
