Abstract
Introduction: Monitored Dosage Systems (MDS) are used by millions of patients in the UK. Also know as multicompartment compliance aids, they are devices that allow for medicines to be dispensed into compartments which are separated by days of the week and times of the day. Published research has highlighted that between 5 and 15% (1) of hospital admissions are due to Drug Related Problems (DRPs). Studies which highlight the risks of MDS and DRPs appear to be limited (2), whereas research into MDS as the cause for hospital admission are scarce. Objective: To analyse hospital admissions due to DRPs and association with MDS. Methods: A retrospective analysis was conducted on four hundred and eighty-seven adult patients hospital admission episodes. The retrospective analysis took place at the Royal Victoria Hospital, a large general teaching hospital in the Belfast Health and Social Care Trust (BHSCT), over a four month period from July 1st to October 31st, 2021. Each episode was analysed for DRPs and MDS causation using the Pharmaceutical Care Network Europe (PCNE)-DRP classification validation V 9.1 system (3) and the Anatomical Therapeutic Chemical code classification system (4). Results: Of the four hundred and eighty-seven admissions included, 155 patients (32%) were using MDS, 43 admissions (9%) related to DRPs, out of these 43 admissions with DRPs; 26 patients (60.5%) were using MDS with DRPs, and three patients (7%) had an MDS related DRP. Medications most frequently implicated were antidepressants, ACE inhibitors, analgesics, and antipsychotics. Conclusion: From this study, MDS have been identified as a cause of hospital admissions due to DRPs. The study highlights that inline with published evidence (5), the cohort of patients more at risk of DRPs are the older population. Older patients frequently use MDS and are already at risk of DRPs as they frequently have multi-morbidities and polypharmacy (6). This study has highlighted that ongoing measures should be considered to reduce DRPs such as deprescribing and regular medication reviews. It also highlights the importance of engaging with patients and carers to increase medication education and awareness.