Pharmacies criticised over amending pill boxes affecting the elderly

Some pharmacies in the UK have been criticised for informing patients using multiple different drugs that they will no longer have blister pack boxes, otherwise known as dosette boxes. The dosette boxes are a form of multi-compartment compliance aids (“MCCAs”) and are delivered to patients addresses.

Why are pharmacies removing them?

Some pharmacies are removing dosette boxes as a form of MCCAs following a statement from The Royal Pharmaceutical Society (“RPS”) on 22 June 2022. The RPS said:

 “While MCCAs are often viewed as a solution, the limited evidence base suggests a lack of patient benefit outcomes and sometimes they can cause harm.”

This stance on dosette boxes was then echoed by a Boots spokesperson who justified their decision saying:

“The latest Royal Pharmaceutical Society guidance indicates that the use of multi-compartment compliance aids is not always the most appropriate option for patients that need support to take their medicines at the right dose and time.”

RPS had said in guidelines published prior to the pandemic, that there are benefits and disadvantages with use of the dosette boxes:

“A multi-compartment compliance aid is one tool amongst many to help with medicines use but other interventions also exist, which as part of a person-centred and quality approach, must also be considered.”

It remains to be seen how many other pharmacy chains will withdraw the boxes. Superdrug and Lloyds Pharmacy say they continue to offer MCCAs, whilst Boots will not. The Association of Independent Multiple Pharmacies says most of its members are continuing to supply patients with MCCAs if they are requested, even though the process is costly.

What is the effect on the elderly?

The pharmacies up and down the UK are proposing new measures. These new measures may include large-print labels and a medicines reminder chart as alternative forms of MCCAs instead of dosette boxes. Prof Gill Livingston, an expert in elderly medicine at University College London stated:

 “Blister packs enable people with mild dementia or some memory problems to take their own medication and remain independent. They can check that they have taken it and they know they have taken the right thing, as it is already sorted out. Later on in dementia or with other disabilities, it enables paid carers and families to help them take their medication and remain in the community and remain as well as possible.”

It will have a knock on effect for carers, families and people with dementia who currently rely on MCCAs.

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