Medicine stability in multi-compartment compliance aids
University College London School of Pharmacy
Multi-compartment compliance aids (MCAs) are used to organise medicines according to the day of the week and time of the day in which they must be taken or administered. In United Kingdom and Australian community pharmacies and hospital pharmacies, medicines are dispensed, removed from their original packaging and repackaged into MCAs. These MCAs assist community-dwelling patients with medicine adherence and care home staff with medicine administration.
There is relatively limited published research, as well as literature supplied from pharmaceutical manufacturers, exploring the stability of medicines repackaged into MCAs . MCAs are not universally air tight, light resistant or moisture impermeable and therefore there is the potential for medicine instability to occur. Active ingredient degradation, formulation changes, degradation product accumulation and changes in physical appearance have the potential to negatively impact patients.
Stability concerns have been raised in studies of prochlorperazine , sodium valproate  and atenolol  repackaged into MCAs, in contrast to studies involving paracetamol  and clozapine . The type of MCA examined and testing conditions used must be considered when interpreting these studies for their applicability to pharmacy practice.
More information concerning medicine stability when repackaged into MCAs is needed to support pharmacists as they prepare MCAs. Pharmaceutical manufacturers can be encouraged to undertake medicine stability testing in MCAs. This data can be provided to pharmaceutical bodies, leading to updated pharmacy guidelines and increased awareness among pharmacists. A comprehensive understanding of the medicine stability risks associated with MCA preparation can be used to determine if they outweigh the benefits of MCA use.
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