Dose administration aids: Pharmacists’ role in improving patient care

Dose administration aid (DAA) usage has become increasinglyprevalent among populations worldwide and as such hasbecome an important part of pharmacy practice. The evidencefor the use of these aids has been favourable in Australiaresulting in 2006 in a community based DAA program beingconsidered by the Australian Government Department ofHealth and Ageing PPSAC (Professional Programs and ServicesAdvisory Committee) and the first phase of this programimplemented in October 2007. The program was establishedunder the Better Community Health Initiative of the 4thCommunity Pharmacy Agreement between the PharmacyGuild of Australia and the Commonwealth Government. Theaim of this program is to reduce medication-relatedhospitalisations and adverse events through improvedmedication management and adherence by people in thecommunity. The most common patient groups that access thisservice include the elderly, who are often on several differentmedications, and patients with cognitive disabilities who mayhave trouble understanding or remembering their dosageregimes.Repackaging of a medication, involving removal from itsprimary packaging invalidates the stability guarantee of themanufacturer. It is in fact the role of the healthcare team toensure optimal patient care by making an informed judgmentas to the effect on the quality and safety of this repackagingprocess. Drug manufacturers, on the whole, tend todiscourage repackaging of medications and there is littlequality data available to support this process. Indeed, onlya small number of medications have been investigated fortheir stability following repackaging into DAAs, namelyatenolol, paracetamol, frusemide, prochlorperazine,sodium valproate, aspirin (dosette boxes) and clozapine.This paper will review the repackaging of medications intoDAAs and the role that the pharmacist plays in thisprocess to improve patient care, in addition to presentingthe Australian research that has contributed substantiallyto the body of information available internationally on thequality implications, relating to the stability of medicinesrepackaged into DAAs.