Supporting patients who may need reasonable adjustments (under the Equality Act: 2010) to take their medicines. Guidance on the use of Monitored Dosage Systems in Devon..

The Guiding Principles – use of monitored dosage systems (MDS) in Devon seek to describe a collective approach that stakeholders should use, when contemplating the use of an MDS device, for patients who may require additional support taking their medicines.

The principal aim is to ensure eligible patients receive the expected outcome from the medicines they are prescribed, through obtaining that support (i.e. reasonable adjustment) as defined by the Equality Act 2010, from their preferred community pharmacy (including online pharmacies), if appropriate.

Some important aspects to highlight whilst contemplating the optimal approach for patients:

• Whilst a multidisciplinary approach is often promoted within healthcare, it is at the community pharmacist’s sole discretion whether to supply medicines in an MDS device for any particular patient, or not.
• In order to support patients under the Equality Act, if an MDS device is not an appropriate reasonable adjustment, it is important to consider and discuss what other support is available to assist patients with their medicines taking.
• 7-day prescriptions should only be provided where there is a clear clinical need to restrict the supply of medications to a patient. There should be no prescribing of 7-day prescriptions to cover the cost of an MDS.

October 2024 Update. Monitored Dosage Systems: Learning From a Coroner’s Report

A recent Coroner’s Report has raised concerns regarding the use of Monitored Dosage Systems (MDS) for managing prescription medications. The investigation into the death of an 82-year-old woman, who had inadvertently taken her husband’s medication for several days, highlighted that the use of identical MDS devices by both persons was an important factor. Both individuals were noted to have cognitive impairment. This case stresses the importance of being able to distinguish between different patients’ MDS devices, especially within the same household, particularly when those patients have cognitive impairments.

NHS Devon MDS Guiding Principles emphasises that the pharmacist should be foremost in deciding whether an MDS device is appropriate.