Multicompartment compliance aids: scoping barriers to their use in practice

Area of Science:

• Pharmacology and Gerontology
• Health Services Research

Background:

• Multicompartment compliance aids (MCAs) are essential tools for improving patient medication adherence.
• However, significant challenges and barriers to their effective use remain under-explored.

Purpose of the Study:

• To systematically identify and analyze the barriers encountered in the utilization of MCAs.
• To propose evidence-based strategies for overcoming these identified obstacles to enhance MCA efficacy.

Main Methods:

• A comprehensive literature search was performed across major databases (Medline, Emcare, CINAHL, Scopus) from inception to June 2024.
• Data analysis employed a multilevel socio-institutional framework (mega, macro, meso, micro-perspectives) to categorize identified barriers.

Main Results:

• Mega-level barriers include a lack of governmental guidelines and funding.
• Macro-level issues involve poor communication between prescribers and pharmacies.
• Meso-level barriers encompass limited patient involvement and perceived loss of autonomy.
• Micro-level challenges stem from device design flaws, inadequate environmental protection, and user-specific impediments (age, cognitive ability, technological complexity).

Conclusions:

• Significant barriers exist across multiple levels impacting MCA use and effectiveness.
• Recommendations include revising MCA service guidelines and remuneration, optimizing interdisciplinary communication, and redesigning devices for better medication stability and user acceptance.