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Multi-compartment compliance aids (MCAs) (in care homes)

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Reasonable adjustments

GPs and other healthcare professionals must make reasonable adjustments to help people take their medicines. The Equality Act 2010 requires such adjustments and MCAs may form part of these.

You might use a range of different MCAs in adult social care settings. These could include dosette boxes, NOMAD® trays, pharmacy sealed blister packs. They should not be the first choice intervention to help people manage their medicines.

Royal Pharmaceutical Society (RPS) report on MCAs

The RPS report did not find enough evidence that MCAs help patients to take their medicines. The report found no evidence that they improve patient outcomes. Evidence does not support using MCAs as a panacea in health or social care policy.

The Care Home Use of Medicines Study (CHUMS)

CHUMS indicated that there's no clear evidence that MCAs reduce medicines administration errors.

But medicines compliance aids might be useful for some people. Before a person uses MCAs, you should take a person-centred approach to assess their needs. Interventions should support the person to take their own medicines where appropriate.

NICE guidance

NICE guideline (SC1) states:

“Care home providers should determine the best system for supplying medicines for each resident based on the resident's health and care needs and the aim of maintaining the resident's independence wherever possible.”

“Pharmacies and doctors supplying medicines to care home providers should ensure they have processes, such as standard operating procedures, in place for all staff who dispense and accuracy check medicines for residents, particularly those using monitored dosage systems.”

Other options

There are other ways to promote people’s independence. Make reasonable adjustments and support the person to use original packs of medicines. Examples of adjustments and support include:

  • reminder charts
  • winged bottle caps
  • large print labels
  • alarms (such as notifications on mobile phones)
  • tablet splitters and “poppa” devices


When you removed from its original packaging, medicine can become unstable. Using medicines this way could be unlicensed. This is when you use a medicine outside its usual product licence or marketing authorisation.

Staff must be able to identify the individual medicines they administer. MCAs can contain many different medicines in one compartment. This makes it more difficult to identify and remove a specific tablet. This might be because the person no longer wants or needs to take it.

Some MCA devices are not child resistant, tamper proof or tamper resistant.

Providers need to consider how people and care staff manage different systems of administration. For example, people could have original packs of medicines as well as those in their MCA. Soluble painkillers are a good example. Where are these kept and how do people manage them?

What happens if new medicines are prescribed part way through a cycle?

MCAs can increase medicines waste. You need to dispose of any medicines left at the end of the pack. This is the same for any medicines that have been removed from their original packaging.

For some people, MCAs may simplify the medicines regimen. They can be a convenient way for them to take their medicines.

Whichever system staff use to administer medicines, they must be trained and competent to do so.

Last updated:
27 January 2020