DDA26: MDS “are a lot more work than your standard dispensing process"

“Monitored Dosage Systems (MDS) are a lot more work than your standard dispensing process. There is also some negotiating to be done with the companies who provide the trays so get haggling!”

Those are the take home messages from DDA Advisor Jacinta Edgar in her presentation, Monitored Dosage Systems (MDS) Workload Vs Safety.

The presentation by Edgar, who is also business partner at Garstang Medical Dispensing Practice and pharmacy manager at Kepple Lane Pharmacy, outlined the pros and cons of supplying MDS:

Pros

Supports adherence
Simple visual prompt
May support independence
Reduces handling of multiple medicines
Clearer routines of repeat medication

Cons

Not suitable for every patient or medication
Mat not actually solve the adherence problem
Medication changes are harder to manage
PRN and non-tray items still need to be managed
Creates additional workload and potential increased errors

But, she said: “Ultimately, the patient needs to be at the centre of the decision and if this is something you are considering doing make sure you have your processes in place prior to starting.”

She highlighted relevant guidance including from the regulator for dispensing practices in England, CQC, which emphasises supporting patients to manage their own medicines where possible and considering the person’s wishes, understanding and abilities.

NICE also recommends considering an MDS pack only after assessment by a healthcare professional identifies a specific need to support adherence, taking into account of the persons needs and preferences and involving the person and relevant carers in the decision

“That being said, do not just move a patient over to MDS because the family or carers want or prefer trays. You must establish what is actually going wrong for the patient. Comments like: “It would be easier for everyone” and “The carer has asked for one” should not make the decision for the patient.”

Included in the presentation are links to guidance and a template dispensary form to support the provision of MDS. Other information covered by the presentation included: alternatives to MDS; the assessment process; MDS supply and changes; 7- or 28-day scripts and charging; and drug stability.

View the presentation slides

Listen to the audio

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