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Apr 2019
Is there still a place for Monitored Dosage Systems in Care Homes?

There was a time when Monitored Dosage Systems (often referred to as multi-compartment compliance aids) were part of everyday life in care homes. In recent years, things have changed. Research has highlighted several areas where Monitored Dosage Systems (MDSs) fall short. This has forced care homes to rethink their medication administration processes.

Guidance from the Royal Pharmaceutical Society states; “The use of original packs of medicines, supported by appropriate pharmaceutical care, should be the preferred intervention for the supply of medicines in the absence of a specific need for a multi-compartment aid in all settings.”

Unfortunately, moving every patient from MDS to original packaging isn’t an overnight process, and MDSs may still be the best option for some individuals. In this article, we look at the advantages and disadvantages of using an MDS, and give advice about how your care home can make the transition to original packaging.

Advantages of MDS

An MDS is a very visual way of managing medicine and can be useful to enable self-management of medicines and promote independence for patients.

Patients who are visually impaired or have difficulty reading might find it easier to have medicines already prepared. Those who struggle with pushing pills from blister packs also find it easier to have them in MDS trays.

Disadvantages of MDS

Perhaps one of the biggest concerns about MDSs is the scope for human error, not to mention the risk of destabilising medicines through exposure to moisture, light, contamination from other medicines or bacteria.

MDSs work well for pills and tablets and have even been adapted for some liquids. However, many medicines cannot be dispensed into MDSs due to their unstable nature. MDSs are also unsuitable for “as required” medication or medicines where the dose varies (such as Warfarin). It can cause confusion if patients have medicines in both MDS trays and original packaging.

An advantage of original packaging is that it comes with the Patient Information Leaflet (PIL) which can be consulted by both care staff and patients if there are any concerns. This helps patients feel more knowledgeable about the medicines they are taking and increases autonomy and choice.

How to move away from MDS

The first stage of moving from MDSs to original packaging is speaking to your pharmacist. They will be able to advise and assist you in making the transition as seamless as possible.

The next step is training staff and helping them understand the benefits to patients. If there is resistance to change, it can make the process unnecessarily difficult. It is important to get your team on board before the change takes place and alleviate concerns in advance. You will also have some patients who are wary of change, and they will need reassurance.

It can be extremely beneficial to install individual medicine cabinets in each patient’s room. This reduces the need for drug trolleys and makes storage easier.

Many care homes adopt a gradual transition, rather than changing all patients over at once. This will be dependent on the size of your care home and the number of patients affected by the changes.

Working with Homecare Pharmacy

The good news is that you don’t have to make the transition without support. At Homecare Pharmacy, we can provide full training and guidance to you and your staff and work with you to transition to original packaging with very little disruption. Whether you have already started making the change, are thinking about changing, or just want more information about the move away from MDSs, we’d love to hear from you. Give us a call and find out how we can help you provide better care for your patients.

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