JMIR Publications

ABSTRACT

Background:

Multidose drug dispensing (MDD) is an adherence-aid where medicines are machine-dispensed in disposable unit bags, usually for a 14-day period. MDD replaces manually filled dosettes in many home care services in Norway Despite evidence that MDD can increase medication adherence, there are also concerns about it reducing patient autonomy and self-care.

Objective:

To explore how MDD users living at home self-manage their medications, and to identify factors influencing medication self-management behavior.

Methods:

We did 17 semi-structured interviews with 19 MDD users in Oslo during August 2019 to February 2020. The interviews took place at the patient’s home. The transcripts from the interviews were thematically analyzed

Results:

All the participants in our study had assistance with medication management from home care. For some, this only included getting the MDD delivered every other week, while for others this included actual help administering medications several times a day. All informants, regardless of how much assistance they received, described that they mostly managed their MDD medications themselves. We found that the daily medicine-taking routines varied among the informants. Some took an active role and felt a need to be involved, others took a passive role and handed over the responsibility for their medicines to others. They also differed in level of interest and knowledge about the medicines they were taking. The respondents described support, information, and cognitive capacity as important factors for them to be able to manage their medicines on their own.

Conclusions:

MDD can support medication self-management, but not for all patients. The degree to which MDD users manage their medications is not necessarily related to their actual capabilities for medication self-management. An interest in self-care and independence, available support, available information and cognitive capacity are factors affecting the degree of autonomy.