| · Asthma
· Homoeopathy
· Controlled drugs
· Compliance aids
· MURs
· Safety (2)
· Retention fees
· The Society (2)
Letters to the Editor
|
Compliance aids
Aids are not the solution to all problems
From Mrs E. Stanley, MRPharmS, and Dr C. G. Cable, MRPharmS
In his letter of 19 August (PJ, 19 August, p220), David
Green highlighted
some issues surrounding the use of compliance aids in patients who have
not been properly assessed, to ascertain their individual needs and requirements.
Described below is a case where an assessment showed a compliance aid
was not necessary for a hospital patient on discharge.
A 70-year-old male was admitted to Western General Hospital with complex
dermatological problems. On admission, the patient was taking three medicines
but, seven months later at the discharge-planning stage, he was receiving
13 medicines. As the patient stayed alone in his own home, senior medical
and nursing staff considered that a compliance aid was necessary to ensure
medicines were taken correctly.
Discussions with the patient indicated that he was bright, intelligent
and alert and viewed the introduction of a compliance aid as a further
erosion of his independence — he was willing and felt competent
to continue to administer his medicines without a compliance aid. The
patient agreed that a medicine reminder chart would be helpful and that
being able to arrange the medicines in an order that suited him would
reduce confusion.
The patient’s views were discussed with medical staff, and it was
agreed that an assessment of the patient’s ability to take his
medicines independently should be carried out. The Western General Hospital
operates a dispensing at discharge system that uses patients’ bedside
medicines lockers. A medicine reminder chart was produced for the patient
and nurses were trained in the patient self-administration policy. One
week before discharge, and under nursing supervision, the patient was
responsible for administering his medicines and his ability to do this
correctly was assessed daily. It became evident quickly that using the
medicine reminder chart allowed the patient to administer his own medicines
and that a compliance aid was not necessary.
Before discharge, the patient’s community pharmacist was alerted
to the current drug therapy and advised of the use of a medicine chart
by the patient. The community pharmacist was willing to amend the reminder
chart should further changes be made to the patients’ therapy.
This case demonstrates that there are alternatives to the use of compliance
aids and that sharing pharmaceutical care between hospital and community
pharmacy can result in tangible patient benefit. The capabilities of
patients should be carefully assessed and the feasibility of incorporating
the patient’s wishes explored.
Liz Stanley
Dermatology Pharmacist
Colin Cable
Royal Pharmaceutical Society Fellow in Pharmaceutics
Western General Hospital,
Edinburgh
|
The
Pharmaceutical Journal