Boots withdrawing dossette box service

[Itsnotallaboutmoney]

www.bbc.co.uk/news/health-61881272.amp

Name changed for this as I really don’t mind it ending up in the Daily Fail for once.

I seriously cannot believe what Boots are planning. For those of us who have elderly parents (particularly with memory issues) who we are trying to persuade to allow help in the home (to no avail) this is a kick in the teeth. Whilst I understand it’s probably time-consuming etc to fill the boxes, the sheer danger of missed tablets, overdosing or the wrong combination as a duty of care from a profession surely outweighs the cost-saving element of providing this service. My in-laws both currently have memory issues and without this service, the lady who comes in to help each day would not have a clue as to what they have taken each day. My own parents at-home care service will not distribute any meds not in a pharmacy-filled dossette box. So where do the elderly and vulnerable go from here?

This morning I couldn’t imagine anything getting me more wound up than having to book a hotel stay in order for my child to get to a public examination today.. but here we are. I sincerely hope Boots have not tried to sneak this in on a day when everyone is watching the rail strike hoping no one has noticed 😡

We just don't get to take our meds properly so aren't able to stay as well as we could. This is already happening.

Also...speaking from an Ambulance Service point of view...

We're supposed to take people into hospital with their medication where possible. Dossette boxes are great because it's just one item, it's named and the contents are listed. If people make up their own boxes (which I see quite often in plastic weekly pill boxes) nobody will know what's in them or who it belongs to if it gets dropped or lost in hospital. We could take all the individual boxes, but some people are on so many tablets we literally need a carrier bag for them all. Some people also take the blister strips out and throw the boxes away which again causes problems because they're not named.

It's so easy for us just to take a dossette box.

It actually says

*medicines at the right dose and time.

"Pharmacists are speaking with patients who we provide with MCCAs to discuss whether it is the right way to support them, depending on their individual circumstances and clinical needs.

"Alternative support might include large-print labels and a medicines reminder chart. In many cases, MCCAs will remain the most appropriate option for the patient, and we will continue to support them in this way."*

Also the police won't take medication for someone they arrest if it is in a plastic box. So the person doesn't get given their medication.

But they won't let anyone new (i.e someone who has just come out of hospital) who needs a blister pack have one so are not continuing to support in that way. Pharmacies can just decide someone doesn't need one even if other HCPs say they do.

@Clevs I always take my own medication in with me, in a plastic box (home equivalent to dosette) and keep it with me to self administer things that I can take orally. Then I just ask them to write me up for IV versions of anything that works better in that form! They're usually fine with letting me self administer my normal oral meds.

You can get a Medibox via any GP delivered to a local pharmacy and they will usually have a delivery service to the frail and housebound

That is a huge problem I'm getting forgetful already and I can see a time where I would need medicine support

This just feels so uncaring

@feathermucker yes it does, but as the daughter of the patient in the article says ‘I received a call to say she would no longer receive the blister packs’. So many people are about to find this to be the case and have to fight to get back into the system. For those of us who are fortunate not to be at the stage of life where the constant worry of elderly parents/care/medication/independence is not an issue, it is not a case of ‘Simple’s’ get a box and to it yourself (not everyone has someone to do this) . Or go on line (not all pharmacies deliver to the most remote parts of the country) Care agencies won’t administer the drugs to your loved ones if they are not in a pharmacy checked blister pack. And as the pp from the ambulance service also points out, taking correctly administered dossette boxes for elderly/vulnerable patients saves much angst when that person Is waiting in a&e without any meds. Or indeed meds that the hospital pharmacy doesn’t stock.

Ans as with the dreadful state of elderly care at home/ in the community, if you are not in the position of facing the uphill struggle of getting decent care for those who have paid their dues into the system, you really don’t want to lose this service on top of it all.

What's a Medibox?

This will be a huge problem fo some.My aunty suffered from dementia and for the last two years of her life she would not have been able to remember which meds to take. The carers wouldn't give them to get unless they were in a blister pack so it would have meant family members driving to her house three times a day. Each trip would have taken at least an hour.

Unfortunately it is coming down to funding. The service has never been funded by the NHS but pharmacies did it as a service to help the elderly and vulnerable. It was mitigated a little by the fact that GP's would do meds as weekly prescriptions so they would get paid to effectively dispense each box.
However the CCG's have recently decided that GP's can only issue monthly prescriptions for all patients so it is now too time consuming and financially non-viable for the pharmacies.

Additionally there was huge scope for medication errors when preparing dossette boxes, and it wasn't always the best option.

An alternative might be Medicines Administration Charts where you mark off each medicine as you take it. Or patients self populating their own dosette boxes at home.

It's sad but this service will be withdrawn more widely soon I feel.

Same thing as a dosette box. Our local GP's just need to ask for them

GP's can request them but a pharmacist is under no obligation to provide one unfortunately.

They have been trying to do this on and off for the past few years. Lloyds did it to one of my clients (I'm a carer) about six months ago. My client rang her GP who gave the pharmacy short shift for trying it on and they have continued to give her blister packs since. She is partially sighted and has arthritis in her hands so is unable to manage pills in their regular packaging.
Adding a charge for this will affect the most vulnerable again. The people who need this service are likely to also be the people already choosing between heating and eating. It's appalling.

@Appzy Realistically a lot of those who desperately need them won't be able to populate them for themselves.

I used to do my mum’s for her, but as a community mental health nurse think it’s invaluable and safe to continue providing this service. My clients don’t have memory problems but can be quite chaotic in their presentation and o have on occasion asked their GP or chemist to provide dosette or blister packs to aid compliance.

I get some of my medication weekly and some fortnightly. I had a review recently and it is staying like that so not sure about all patients having monthly meds?

Where do you get a medication administration chart from?

Ask for them from who?

Surely the pharmacies would have told my Care Co this was available? Which leads me to think it isn't actually available.

Why don't they just charge for blister packs? I'd happily pay.

I would worry about the statement that pharmacists will talk to patients to decide what is the best way of giving them their medication. My mother was in denial about the state of her memory, and if a pharmacist had asked her whether she needed a dosette box she'd have strongly denied it. But she really, really needed it.

They are here. I requested one on Friday

It's true what you say about a charge. But I'd rather be cold and hungry if it means I can take my medication properly.

Here's a few - hopefully you'll find some that will work for you and what you need:

www.pharmacy2u.co.uk/help-and-support/my-account/can-i-have-my-medication-sent-in-weekly-pill-packs-blister-packs/ - they refer you to PillTime:
portal.pilltime.co.uk/patient/s/pharmacy2u-sign-up

www.dosettepharmacy.co.uk/ - says they serve nationally as well as being a physical local pharmacy in the Nottingham area

It's also worth approaching your local pharmacies - I was in mine today for an acute prescription and a lady came in to collect a blister pack with a months worth of pills in it, so that particular pharmacy (in Cornwall FWIW) definitely offers them.

I know Lloyds withdrew the service a few years ago.

It may also be worth asking your GP practice if they know who offers it - or if they can find out for you rather than you having to do all the legwork. The District Nurses for an area would probably know as well.