A range of solutions are available to support patients with taking their medication as prescribed. The MASDA is intended to facilitate discussions between practitioners and patients to personalise these solutions. The decision aid comprises an algorithm that has been informed by a programme of research regarding medication adherence and compliance aids led by Dr Debi Bhattacharya.
We developed the MASDA algorithm through collating a programme of research regarding the patient and practitioner experience of using and recommending medication compliance aids respectively. We also involved these key stakeholders in developing and validating a tool to identify a patient’s main barriers to taking medicines as prescribed (IMAB-Q) and reviewed the wider literature to identify appropriate solutions to these barriers.
Below are the individual elements that have contributed to its development:
A validated tool to identify a patient’s main barriers to taking medication as prescribed.
The feasibility of determining the effectiveness and cost-effectiveness of medication organisation devices compared with usual care for older people in a community setting: Systematic review of the health and societal effects of medication organisation devices.
The message from this review was that evidence regarding the effects of pillboxes is limited; they may help people who are unintentionally not taking their medication as prescribed. The problem with most pillbox trials is that few delineate between patients for whom intentional or unintentional barriers to taking medication as prescribed dominate.
The message from this study was that several pillboxes widely used in practice cannot be opened by patients, particularly those with cognitive impairment.
Indications for Multi compartment Compliance Aids (MCA) provision.
This review concluded that currently used assessment techniques for pharmacy teams may be inadequate for accurately identifying patients requiring a pillbox.