Dose Administration Aid Service in Community Pharmacies: Characterization and Impact Assessment.

André Vicente,Beatriz Mónico,Mónica Lourenço,Olga Lourenço

doi:10.3390/pharmacy9040190

André Vicente, Beatriz Mónico + Show 2 more

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https://doi.org/10.3390/pharmacy9040190

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Abstract

Adherence to therapies is a primary determinant of treatment success. Lack of medication adherence is often associated with medical and psychosocial issues due to complications from underlying conditions and is an enormous waste of medical resources. Dose Administration Aid Service (DAAS) can be seen as part of the solution, allowing individual medicine doses to be organized according to the dosing schedule determined by the patient’s prescriber. The most recent systematic reviews admit the possibility of a positive impact of this service. In line with this background, the study reported in this paper aimed to characterize DAAS implementation in Portugal and understand the perceptions of pharmacists and owners of community pharmacies regarding the impact of DAAS, preferred methodology types, and State contribution. The study was guided by qualitative description methodology and reported using the consolidated criteria for reporting qualitative research (COREQ) checklist. Data were collected through semi-structured interviews with 18 pharmacists and/or owners of community pharmacies. Using qualitative content analysis, we identified categories that revealed that automated weekly methodology is the preferred methodology, because of its easiness of use and lower cost of preparation. However, the investment cost was felt to be too high by the participants considering the number of potential users for implementation in practice. Participants were also unanimous in recognizing that DAAS has a very positive impact in terms of safety and medication adherence, and the majority agreed that it also helped reduce medication waste. Implications of these findings for medication adherence are discussed.

Highlights

Older people, defined as those aged 65 years and older, often have multiple chronic health problems that require ongoing monitoring and medical interventions
The aim of this study is, to characterize Dose Administration Aid Service (DAAS) implementation in Portugal and understand the perceptions of pharmacists and/or owners of community pharmacies regarding the impact of DAAS, preferred methodology types, and State contribution
Understand the perceptions of pharmacists and/or owners of community pharmacies regarding the impact of DAAS, preferred methodology types, and State contribution

Summary

Introduction

Older people, defined as those aged 65 years and older, often have multiple chronic health problems that require ongoing monitoring and medical interventions. This, and the increasing supporting evidence regarding multi-drug regimens in the management of these chronic conditions, mean that polypharmacy is often unavoidable in older people [1]. There are several definitions of polypharmacy, with the most consensual one being the simultaneous use of five or more medications [2]. Considering these complex multi-drug regimens and the decline in cognitive and physical abilities associated with aging, it comes as no surprise that medication errors often occur and may be responsible for adverse drug events (ADEs), unplanned hospitalizations, and increased morbidity, mortality, and healthcare costs [3,4,5,6,7,8]. Medication adherence is defined by the WHO as “the degree to which the person’s behavior corresponds with the agreed recommendations from a health care provider” [9]

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