Appropriate use of dose administration aids

small study focusing on older people met the criteria for inclusion.This study reported a non-significant effect on the mean number of missed doses and clinical outcomes.16 The UK National Institute for Health and Clinical Excellence reviewed the use of dosing aids.It concluded that the evidence for their benefits was not strong enough to recommend widespread use and they should only be used to overcome practical problems if there is a specific need.17 There has been limited evaluation of sachet dosing aids and automated medication dispensing devices.15 A qualitative study of Danish patients using a sachet system found that it did not eliminate non-adherence, especially conscious non-adherence, or stockpiling of medicines in the home.18 A large, non-randomised, retrospective cohort study in the USA reported that a sachet dosing system combined with regular telephone follow-up improved medication refill adherence, but did not reduce health service use or costs in a middle-aged population with multiple comorbidities.19 Two low quality studies reported that automated dispensing devices led to fewer missed doses compared with manually operated dosing aids, 16,20 but the differences were unlikely to be clinically important.Few trials on dose administration aids have been conducted in Australia.However, unpublished Australian studies and clinical experience suggest that dosing aids provided as part of a medicines management service by community pharmacies may benefit appropriately selected patients (Box 1).5,10,21 These studies have led to government-subsidised dosing aid programs in Australia and professional practice standards to support this service.