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The role of dose administration aids in medication management for older people

While medicine use in the older population is high, adherence to prescribed regimens is often suboptimal. Older people may be unintentionally non‐adherent due to difficulties managing and manipulating medicines. Dose administration aids are medicine packaging systems designed to reduce unintentional non‐adherence by simplifying management of oral medicines and enabling people to see if they have taken their medicines. Evidence suggests dose administration aids can improve medicine adherence but the size of this benefit is unclear and there is little evidence from controlled trials in older people or people taking multiple medicines. There is no conclusive evidence that they improve health outcomes. Use of an aid is limited to medicines suitable and stable for repackaging. Other limitations include reduced user medicine knowledge and autonomy, risk of filling discrepancies and incorrect use, and increased complexity at transitions of care. Upon consideration of a dose administration aid, a comprehensive assessment of the patient's medication management and a review of their medicines is required. Dose administration aids are best combined with other medication management strategies, such as medicine lists and education, and are most effective in people who are motivated to take their medicines and who have the required physical and cognitive capacity to use an aid.