Aim: Multi-compartment medication compliance aids (MCAs) aim to support medication adherence and administration. Many older people have their medications supplied in a pharmacy-filled MCA (pMCA), despite growing evidence of increased risks of medication-related harm and inappropriate prescribing practices. Little is known about patients’ perspectives on the various MCAs and their impact. The aim was to determine patient views on pMCAs. Methods: A questionnaire-survey of adults over 65 years old, who use, have declined or discontinued a pMCA. Participants were recruited from inpatient, outpatient and community settings in central London. 88 participants were recruited. Responses were analysed using thematic analysis. Results: 61 participants used, 5 had discontinued and 22 had declined a pMCA. Those not using a pMCA often self-filled an MCA of their choice. Participants’ views on pMCAs fell into three themes: Polypharmacy and medication supply systems; Autonomy and independence; and Design of products. The majority of those using pMCAs would not revert to original medication packaging. For some, the convenience of the aid in managing polypharmacy overrode the loss of autonomy. Those who had stopped or declined pMCAs highlighted the importance of control and knowledge of their medications. The environmental impact of the devices caused concern across all groups. Conclusion: Whether self-filled or pharmacy-filled, MCAs were deemed useful in supporting adherence. An individualised approach to medication rationalisation would reduce the burden of polypharmacy and potentially the need for any form of MCA. Redesign of pMCAs and systems surrounding their use would be beneficial at an individual and global level.