Dose Administration Aid Service - information for veterans

the right dose - helping veterans manage their medicine 

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Update from the Principal Medical Adviser

The Dose Administration Aid (DAA) Service became available, at no cost to veterans, on 1 March 2008. The Department of Veterans’ Affairs (DVA) has now simplified this program to make the service more accessible to veterans to help them manage their medicine.

In Australia each year, there are 140,000 people admitted to hospital because of medication misadventure. As many veterans are elderly and take a high number of medicines, they are at particular risk. This program is therefore important for veterans.

Medication mismanagement could take the form of unintentional non-compliance, confusion, missed or double dosing.  A DAA may help alleviate those problems associated with mismanaging your medicines.

DVA would like to take this opportunity to encourage a coordinated approach between you, your doctor and your pharmacist to improve the management of your medicines.

This booklet has been developed to assist you in commencing your DAA Service. 

If you have any questions in relation to the service or any aspect of this letter, please contact DVA on 1300 556 906.

Yours sincerely

Dr GT Killer AO
Principal Medical Adviser

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What is the Dose Administration Aid Service?

The Dose Administration Aid (DAA) Service aims to help veterans, war widows and other DVA clients safely and easily manage their medicines under the care of their doctor and pharmacist.

A DAA is essentially a compartmentalized device that stores multiple medications according to a dose schedule. They are a simple way of ensuring that you take the right dose of the right medicine at the right time.

Veterans who are eligible and who will benefit from the DAA Service will have their DAA packed by their pharmacist each week.  The pharmacist will also work in consultation with your doctor to assess your suitability for the service and to monitor your medication usage.

DVA strongly recommends that your doctor refers you to your pharmacist for a Home Medicines Review before you commence using a DAA. In a Home Medicines Review your pharmacist will assess your medication use and the suitability of a DAA. However, DVA understands that not all veterans will have access to this service and your GP may decide to prescribe a DAA for you without this review.

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Who is eligible?

A patient who holds a Gold, White or Orange Repatriation Card.

Veterans must also be living in the community and not residing in a Residential Care Facility, hostel or hospital.

If a veteran is already using and paying for a DAA that is packed by the pharmacist they are eligible to receive the DVA DAA Service.

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How will the DAA Service help me?

If you take tablets and capsules your pharmacist will pack them into a sealed device that has compartments so that it makes it easy to know when it is the right time to take your medicine.

The DAA will help:

  • If you feel confused about which medicines to take and when to take them; or
  • If you take a lot of medicines; or
  • If you are forgetful in taking your medicines; or
  • If you need help with tasks in order to live at home.

You may decide that a DAA will help you or your carer, community nurse, pharmacist or doctor may suggest this to you.

The DAA Service will help you to manage solid medicines you take by mouth. It is not suitable for some medicines such as inhalers, creams, suppositories or drops. If you are not sure, ask your pharmacist or GP.

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Steps for the veteran in using the DAA Service

The DAA Service is provided to you in 4 steps during a six-month cycle.

Ongoing care is provided by the the GP and pharmacist so that aservice is provided rather than simply a device.

Veterans Process Diagram

Download the printable version of the Veterans Process Diagram (PDF 549Kb)

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How does the DAA Service work?

The DAA Service involves two stages.

Stage 1:    Assessment by your GP that your will benefit from the DAA Service. To assist in the assessment your GP may refer you to your pharmacist for a Home Medicines Review.
Stage 2: A six-month service DAA Service which is reviewed by your pharmacist and GP to ensure that you continue to benefit from the service.

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What do I do?

If you are already using a DAA

You will need to visit your GP to:

  • obtain a six-month prescription for the DVA DAA Service
  • discuss with your GP the possibility of being referred to your Pharmacist for a Home Medicines Review if you have not had a review in the previous 12 months
  • obtain medicine prescriptions for your pharmacist to fill your DAA
  • obtain a prescription for the six-month review that will be done by your pharmacist.

If you want to use a DAA for the first time

You will need to visit your GP to:

  • discuss if you will benefit from the DAA Service
  • obtain a referral to your pharmacist for a Home Medicines Review if this service is available
  • if a Home Medicines Review is not available, your GP is able to decide if you will benefit from using the DAA Service
  • obtain a six-month prescription for the DAA Service
  • obtain medicine prescriptions for your pharmacist to fill your DAA
  • obtain a prescription for the six-month review that will be done by your pharmacist.

Your GP will need to know if you have seen any other health professionals who have prescribed or recommended medicines (including non-prescription medicines) and if you require any prescriptions.  If the pharmacist does not have a valid prescription for each of your medicines they will not be able to fill your DAA.

You will need to visit the pharmacy to:

  • make an appointment for a Home Medicines Review if this service is available
  • collect the DAA each week (which may be delivered by your pharmacy or your carer may collect your DAA for you)
  • provide prescriptions so that the pharmacist can fill the DAA
  • notify the pharmacist of any changes to your medicines
  • discuss any concerns you have about your DAA
  • participate in your six-month review.

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Updating prescriptions

You will still need to obtain prescriptions for the various medicines that are being used in your DAA. Your community pharmacy will be filling your prescriptions and will advise you when your prescriptions for the DAA are running out and to see your doctor for more.

Talk to your pharmacist regularly to make sure there are enough prescriptions for your medicines to fill your DAA. Without a prescription the pharmacist will be unable to fill your DAA.

Generally, your pharmacist will advise you to see your doctor after you have had a six-month review of your DAA Service so that you can obtain a new prescription for the service.

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Your responsibilities

It is important that you:

  • notify your GP and pharmacist of any changes to your medicines
  • discuss any issues or concerns you have with your GP or pharmacist
  • provide the pharmacist with sufficient prescriptions to fill your DAA
  • arrange for the collection or delivery of your DAA each week
  • participate in the six-month DAA Service review.

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Reviews

Veterans Six Month Review

After you have used the DAA Service for six months your pharmacist will review with you how you are managing with the DAA and if it is continuing to help you manage your medicine.  Your GP, informed by your pharmacist, will assess your suitability to continue using the DAA Service for another six months.

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Cost

DVA provides the DAA Service free to eligible veterans, although veterans will still have to make a co-payment for the medicines used to fill the DAA.  If you the veteran have your DAA delivered by the pharmacy, you will need to meet any charges for delivery.

The six-month assessment of the veteran that is conducted by the pharmacist is also a free service.

Please note that DAA Service will not count towards the Australian Government pharmaceutical safety net.

All DVA Treatment Card holders, including Orange Card holders are eligible for the DAA Service. Your Repatriation Pharmaceutical Benefits Card (PRBC) (Orange Card) indentifies you as being eligible for pharmaceutical benefits for most conditions and entitles you to obtain your prescribed medicines at the concessional rate. The Orange Card can only be used for pharmaceuticals and a DAA Service. The Orange Card cannot be used for any medical or other health care treatment including GP consultations.

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Your consent is required

You will be asked to provide consent to the DAA Service, to consent to your GP and pharmacist sharing your medication records, and to consent to the DAA Service six-month review.

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Step-by-step guide


1

Decide that a DAA may help you manage your medicines or you may already be using a DAA and would like to use the DVA DAA Service.

2

See your GP and get a referral for a Home Medicines Review if this service is available in your region.

3

Have a Home Medicines Review if your GP has referred you. The Home Medicines Review is able to recommend a DAA Service.

4

Visit your GP with the recommendation for a DAA Service and get a prescription for six-months (one week with 25 repeats). You will also need a prescription for the six-month review.

5

Make sure all your medicines (including non-prescription) are with your pharmacist to be put in a DAA. Make sure your pharmacist has all of your prescriptions.

6

Arrange for the collection or delivery of your DAA every week.

7

Make sure you have valid prescriptions for all of your medicines, and see your doctor for more if you do not.

8

Have a six-month review with your pharmacist who will consult with your GP about continuing the DAA Service.

9

See your doctor for another six month prescription.

10

Start the six month service again (Step 5)

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Frequently Asked Questions

What is a Dose Administration Aid?

A Dose Administration Aid (DAA) is a device provided and packed by a pharmacist to store and dispense pills in a controlled and easily used manner.  There are many different types of available to suit hands of varying dexterity.

How much does it cost?

Eligible veterans are provided the DAA Service free of charge, but please note that DAA prescriptions do not count towards the safety net. DVA pays the doctor and pharmacist for providing your DAA Service.

How do I use the DAA?

DAAs store a week of pills in compartments labeled with the day and time they should be taken. Each week you will take your DAA to your Community Pharmacist to have it replaced.  Your health team – your pharmacist and your doctor – will be able to answer any questions you may have about the DAA Service.

What consent is required?

You will be asked to provide consent to the DAA Service, your GP and pharmacist sharing your medication records, and to the six-month reviews.

What DAAs are approved for use by the DAA Service?

DVA DAA devices must comply with the Pharmaceutical Society of Australia’s Standards and Guidelines.  Dosette boxes or other DAAs not filled by a pharmacist, or those that can be modified, are ineligible for the DVA DAA Service.

What type of DAA do I have to use?

The Department of Veterans’ Affairs does not endorse any one particular brand of DAA over another.  DVA does require the DAA supplied by your pharmacist to meet minimum standards.

What if I have my own DAA?

You may apply for the DVA DAA Service even if you are using your own DAA, although DVA makes no retrospective payments for DAAs.

How long can I stay on the DAA Service?

You are able to continue on the DAA Service as long as you need it and your GP authorizes it.

Can I stop the DAA Service?

Yes, at any time. Just contact your pharmacist and GP.

Can I restart the DAA Service if I stop it?

Yes, you can restart the DAA Service if your GP determines that you would benefit from it.

What types of medicines can be used in a DAA?

A DAA is used to hold only solid oral medications taken regularly.  DAAs are not suitable for suppositories, liquid medications, or those requiring refrigeration.  Your pharmacist will advise which medications are appropriate for a DAA.

Can a veteran residing in Residential Care receive the DAA Service?

No. Veterans residing in Residential Care (either low or high level care), hotels or hospitals are ineligible for the DAA Service.

Does the DAA Service affect my DVA entitlement?

The DVA DAA Service does not affect your entitlement in any way.

Does it count toward the Safety Net?

No. the prescriptions issued for the DAA Service does not count towards the safety net, however the prescriptions for the medications to fill the DAA do count.

How often will I need to visit the GP?

You will need to visit your GP to:

  • discuss the need for the DAA Service
  • obtain a referral to your pharmacist for a Home Medicines Review if this service is available for you in your community. A Home Medicines Review is able to recommend the DAA Service
  • obtain a prescription for a DAA Service for six months and obtain a prescription for the six-month review
  • obtain medicine prescriptions with which your pharmacist can fill your DAA
  • participate in your regular six month review.

I have an Orange Card.  Why do I have to pay for consultations with my LMO?

Your Repatriation Pharmaceutical Benefits Card (RPBC) (Orange Card) identifies you as being eligible for pharmaceutical benefits for most conditions and entitles you to obtain your prescribed medications at the concessional rate. The Orange Card cannot be used for any medical or other health care treatment.

Does the DAA Service affect my annual Home Medicines Review?

The DAA Service does not prevent veterans from receiving an annual Home Medicines Review (HMR). The Home Medicines Review should be ordered separately to the DAA Service.

What if I have had a Home Medicines review recently? Do I need to have another one?

If you have had a Home Medicines Review (HMR) in the last six months and want to apply for the DAA Service, you must visit your GP who will assess whether you require another HMR before commencing the six-month DAA Service.

What support does the pharmacist provide?

  • The pharmacist will provide assistance and information and will regularly monitor your progress to ensure continued safe and correct use of the DAA.
  • The pharmacist will provide written information at the start of the DAA Service.
  • The pharmacist will advise your doctor based on their weekly observations and also the six-month reviews.

What do I need to tell the pharmacist?

Your community pharmacy needs to know about all of the medicines (including non-prescription medicines) that you are taking so that they can be considered for the DAA Service.  If possible, choose just one pharmacy to dispense all your prescriptions. This will help you and your pharmacist to keep track of your medicines. If you use more than one pharmacy, ensure that you hand the new medicines to the pharmacy supplying your DAA.

How often will I need to visit the pharmacy?

Since DAAs will usually contain enough medicine for seven days, you will need to have your DAA prescription filled weekly at your community pharmacy. Discuss a different routine with your pharmacist if this is not suitable. If you are not able to collect the DAA yourself every week, a carer may be able to collect it for you or your community pharmacy may have a delivery service. The cost of a delivery service is not covered by DVA.

Can a carer or family member pick up my DAA from the Pharmacy on my behalf?

Yes, as long as the pharmacy agrees.  You should discuss this with the pharmacy when being assessed for the DAA Service.

What is the difference between the DAA Program offered by the Pharmacy Guild of Australia and the DAA Service by DVA?

There are three differences.

  • The cost to the patient.
    The Pharmacy Guild of Australia’s DAA Program may be recommended by a pharmacist or GP and generally requires the patient to make a payment to the pharmacist for the service. The DVA DAA Service is free to the eligible veteran.
  • A Home Medicines Review
    The DVA DAA Service strongly recommends that the veteran receive a Home Medicines Review where this service is available. The pharmacist reviews the veteran’s medicine, often in the veteran’s home, is able to assess all of the medications and make recommendations to the veteran’s GP, including the need for a DAA.
  • A six-month review
    The DVA DAA Service requires that the veteran receive a six-month assessment by the community pharmacist who will make a recommendation to the veteran’s GP on continuity of the DAA Service.

What happens if my medication changes?

If your medication changes (for example as a result of a trip to hospital), notify your GP and provide new prescriptions to your pharmacist as soon as possible so that they can refill your DAA.

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