by Sandra Fuson
Not taking prescribed medication – noncompliance – can have serious health consequences. The reasons why people forget or don’t take medications are varied. Maybe the doctor didn’t explain how to take it properly. Maybe they feel better and think they don’t need the medicine anymore. Maybe they just forgot.
Anyone who cares for someone with a chronic illness for very long will soon realize there is much to be learned about how to organize medications. There are many ways to remind patients which medications to take when. In addition, what about those patients who insist on taking medications on their own? Are there ways to remind them about medicines that are unobtrusive and fit into the routine of every day life? How about a system that can help several caregivers adapt to the schedule without too much explanation?
The most common type of medication system is the simple box with slots for different times of day. Caregivers sort out medications generally up to one week in advance and place it in the correct slot. At the appropriate time, the patient or the caregiver can tell at a moment’s glance which medicines need to be taken when.
Pill boxes can be purchased at almost any store, whether it’s your local drug store or your larger discount stores. Depending on the number of doses needed every day will determine the type purchases. Cost isn’t generally a factor since these are the least expensive option on the market today, starting generally at less than $10.
There are electronic pill boxes that can sound an alarm and store medications at the same time. These are more expensive depending on the brand ordered and the number of features required by the patient for their medication system.
There are a variety of reminder alarms on the market today. These can range from a watch that the patient or caregiver wears with alarms that sound at various times throughout the day to computer software that can be programmed to let people know when it is time to take the medication.
Watches can be programmed with specific medication information, patient’s name, doctor’s name, and a variety of other information depending on the type of watch ordered. Alarms can be set to vibrate or emit an electronic alarm when it is time to take a new medicine.
Patients who may have difficulty seeing smaller print may have difficulty with this type of reminder. In addition, the elderly are sometimes bothered by electronic beeps emitted by some of these watches, so this may be a factor when making this decision.
Other electronic alarms can look similar to an alarm clock and have settings for several different medications. These need to be programmed in advance by the caregiver so that the patient is not easily confused by the device. One alarm vibrates strong enough when placed inside a pillowcase that it will wake the patient to remind them that they need to take medication.
Another option is a pager device that when set, can sound an alarm or vibrate to remind patients to take their medications. Pagers generally have a larger digital read-out than does a watch, so this option may work better for sight-impaired patients.
Software systems may work well for caregivers who are computer-savvy and have time to devote to managing the system. In addition, some software programs on the market can show trends in giving medication and offer report features that allow physicians to track compliance to dosing instructions. Specialized software, however, may not be needed, as a simple calendar function can offer the ability to remind caregivers when medicines need to be administered. As with any other medication system, software needs to be programmed in order to be utilized effectively.
Electronic reminder systems are relatively inexpensive, but not generally covered by insurance. Prices can start as low as $35 for alarms and depending on the number of features needed, the price will increase proportionately. There are numerous websites that carry these products (See “Shopping for Reminder Systems”) so that consumers on a limited income can make wise decisions with their shopping dollars.
Finally, there are options for individuals who want to not only program a reminder, but dispense the medications at the same time. This may be an excellent option for the caregiver who is away from the home at various times of the day. It helps remind the patient when to take the necessary medications, yet it also serves to dispense the medications at the same time. There are no bottles to sift through and no opportunity to take too much or not enough of a particular medication. Some dispensers can even accept liquid medications.
Dispensers are the most expensive option on the market, however, and may not easily fit into every budget. Programming needs to be done in advance and the caregiver will want to monitor the system to be certain that it is working correctly before depending on it for dispensing medication while they are away for an extended period.
Also, the dispenser may or may not be portable within the house as they often require an outlet rather than batteries. Some of these can also be remotely monitored to ensure patient compliance and to be certain that the dispenser is working properly. Remote monitoring is generally available for a monthly subscription. In order to provide remote monitoring, a phone outlet is needed as well.
Depending on the situation in the home, there are a variety of options available on the market. If caregiving is provided remotely or dispersed throughout the day, it may be more expensive to purchase a pill dispenser. On the other hand, some caregivers prefer the peace of mind that it provides.
Likewise, some patients prefer a smaller, more discrete option that a watch or pager provides. Pill boxes work well for many patients who need only to have the medication separated for them and they can take them on the needed schedule. Some caregivers prefer a written schedule, and thus, can take advantage of software systems that are available today. Designing the medication system in advance will help the caregiver and patient decide which reminder system will work in the household.