medication reminder aids assignment

Dosage / Medication Reminder Aids Assignment pdf

Table of Contents

Dosage and medication reminder aids play a crucial role in healthcare by helping individuals adhere to their prescribed medication regimens. This paper explores the significance of these aids in improving medication adherence and patient outcomes. We discuss the challenges associated with medication non-adherence and the potential consequences of missed doses. Furthermore, we examine various dosage and medication reminder aids, including traditional methods such as pill organizers and alarms, as well as modern technological solutions like medication reminder apps and smart pill dispensers.

By understanding the importance of medication adherence and the available reminder aids, healthcare professionals and patients can work together to promote better health outcomes.

Introduction

Medication adherence is a critical aspect of managing chronic conditions and preventing complications. However, studies consistently show that a significant portion of patients fail to adhere to their prescribed medication regimens. This non-adherence can lead to worsening health conditions, increased hospitalizations, and higher healthcare costs. One of the primary reasons for medication non-adherence is forgetfulness.

People lead busy lives and may struggle to remember to take their medications as prescribed. This is where dosage and medication reminder aids become invaluable. These aids help individuals remember to take their medications on time and in the correct dosage, thereby improving adherence and reducing the risk of adverse health outcomes.

Five Rights of Medication

The “five rights” of medication administration serve as fundamental principles to ensure patient safety and the effectiveness of medication therapy. These rights include:

• Right patient: Ensuring that the medication is administered to the correct patient by verifying their identity using two patient identifiers, such as name and date of birth.
• Right medication: Confirming that the medication being administered is the one prescribed for the patient by checking the prescription label and comparing it to the medication order.
• Right dose: Administering the correct dosage of the medication as prescribed by the healthcare provider, taking into account factors such as the patient’s age, weight, and clinical condition.
• Right route: Ensuring that the medication is administered via the correct route (e.g., oral, intravenous, topical) as prescribed by the healthcare provider.
• Right time: Administering the medication at the correct time according to the prescribed schedule, taking into consideration factors such as the medication’s pharmacokinetics and the patient’s meal times.

You May Like: Jan Aushadhi and other Generic Medicine initiatives in India

You May Like: Overview of Pharmacy associations in India

Adhering to these five rights helps prevent medication errors and ensures the safe and effective use of medications.

Remembering for Medications

Remembering to take medications can be challenging, especially for individuals with complex medication regimens or cognitive impairments. Fortunately, there are several strategies and aids that can help improve medication adherence:

• Pill organizers: These are containers with compartments for organizing medications by day and time. Pill organizers help patients keep track of their medications and ensure they take the right pills at the right times.
• Alarms and reminders: Setting alarms on smartphones or using medication reminder apps can help patients remember to take their medications at scheduled times. These reminders can be customized based on the patient’s medication schedule and preferences.
• Associating medication-taking with daily routines: Linking medication administration to routine activities such as brushing teeth or eating meals can help establish a consistent medication-taking habit.
• Involving family members or caregivers: Family members or caregivers can play a vital role in supporting medication adherence by helping patients remember to take their medications, refilling prescriptions, and monitoring for any adverse reactions or side effects.

Some Extra Remembering Aids to Take Medication

In addition to traditional methods, several innovative technologies and devices have been developed to enhance medication adherence:

• Medication reminder apps: These smartphone apps allow users to set up medication schedules, receive reminders, and track adherence over time. Some apps also offer features such as medication refill reminders and medication interaction alerts.
• Smart pill dispensers: These devices dispense medications at pre-programmed times and can be set up to provide audible or visual reminders to take medications. Some smart pill dispensers also offer features like remote monitoring and notifications for missed doses.
• Wearable devices: Wearable devices, such as smartwatches and activity trackers, can be programmed to send medication reminders to users’ wrists. These devices offer the convenience of constant reminders without the need for a separate smartphone or pill dispenser.
• Integrated healthcare platforms: Some healthcare systems and pharmacies offer integrated platforms that allow patients to access their medication schedules, receive reminders, and communicate with healthcare providers seamlessly. These platforms may also offer medication management tools and educational resources to support adherence.

By leveraging these extra remembering aids, patients can personalize their medication management strategies and improve their overall adherence to prescribed regimens.

In conclusion, dosage and medication reminder aids are essential tools for promoting medication adherence and improving patient outcomes. By understanding the five rights of medication administration and exploring various remembering aids, healthcare professionals and patients can work together to overcome barriers to adherence and optimize medication therapy.

About The Author

Related Posts

Overview of Pharmacy associations in India

Jan Aushadhi and other Generic Medicine initiatives in India

Leave a comment cancel reply.

Your email address will not be published. Required fields are marked *

Save my name, email, and website in this browser for the next time I comment.

An official website of the United States government

The .gov means it’s official. Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

The site is secure. The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

• Publications
• Account settings

Preview improvements coming to the PMC website in October 2024. Learn More or Try it out now .

• Advanced Search
• Journal List
• Pharmacy (Basel)

Dose Administration Aid Service in Community Pharmacies: Characterization and Impact Assessment

André vicente.

1 FCS-UBI, Faculty of Health Sciences, University of Beira Interior, Avenida Infante D. Henrique, 6200-506 Covilhã, Portugal; tp.ibu.eduascf@98473a

Beatriz Mónico

2 Holon Pharmacies, 1100-100 Lisboa, Portugal; moc.liamg@ocinomczirtaeb

Mónica Lourenço

3 CIDTFF, Campus Universitário de Santiago, University of Aveiro, 3810-193 Aveiro, Portugal; tp.au@ocneruolacinom

Olga Lourenço

4 CICS-UBI, Health Sciences Research Centre, University of Beira Interior, Avenida Infante D. Henrique, 6200-506 Covilhã, Portugal

Associated Data

The data that support the findings are available from the corresponding author upon reasonable request.

Adherence to therapies is a primary determinant of treatment success. Lack of medication adherence is often associated with medical and psychosocial issues due to complications from underlying conditions and is an enormous waste of medical resources. Dose Administration Aid Service (DAAS) can be seen as part of the solution, allowing individual medicine doses to be organized according to the dosing schedule determined by the patient’s prescriber. The most recent systematic reviews admit the possibility of a positive impact of this service. In line with this background, the study reported in this paper aimed to characterize DAAS implementation in Portugal and understand the perceptions of pharmacists and owners of community pharmacies regarding the impact of DAAS, preferred methodology types, and State contribution. The study was guided by qualitative description methodology and reported using the consolidated criteria for reporting qualitative research (COREQ) checklist. Data were collected through semi-structured interviews with 18 pharmacists and/or owners of community pharmacies. Using qualitative content analysis, we identified categories that revealed that automated weekly methodology is the preferred methodology, because of its easiness of use and lower cost of preparation. However, the investment cost was felt to be too high by the participants considering the number of potential users for implementation in practice. Participants were also unanimous in recognizing that DAAS has a very positive impact in terms of safety and medication adherence, and the majority agreed that it also helped reduce medication waste. Implications of these findings for medication adherence are discussed.

1. Introduction

Older people, defined as those aged 65 years and older, often have multiple chronic health problems that require ongoing monitoring and medical interventions. This, and the increasing supporting evidence regarding multi-drug regimens in the management of these chronic conditions, mean that polypharmacy is often unavoidable in older people [ 1 ]. There are several definitions of polypharmacy, with the most consensual one being the simultaneous use of five or more medications [ 2 ].

Considering these complex multi-drug regimens and the decline in cognitive and physical abilities associated with aging, it comes as no surprise that medication errors often occur and may be responsible for adverse drug events (ADEs), unplanned hospitalizations, and increased morbidity, mortality, and healthcare costs [ 3 , 4 , 5 , 6 , 7 , 8 ]. Therefore, guaranteeing the correct, safe, and effective use of the prescribed medication is one of the greatest challenges faced by healthcare professionals, and is also recognized by the World Health Organization (WHO) as a strategy to tackle chronic health conditions effectively [ 9 ].

Medication adherence is defined by the WHO as “the degree to which the person’s behavior corresponds with the agreed recommendations from a health care provider” [ 9 ]. It is a measure of the person’s ability to accurately follow a prescribed medication regimen.

Non-adherence represents a major risk factor in chronic conditions and has become a large burden in healthcare systems. Non-adherence can be classified into intentional—when a person deliberately decides not to take their medication, or non-intentional—due to forgetfulness, lack of understanding, complexity of the regimen, or physical limitations [ 1 , 10 ].

The development of effective interventions to improve adherence is a challenge many researchers and health professionals have been pursuing for decades [ 11 ]. Various authors suggest that Dose Administration Aids (DAA), especially the medication reminder packaging, may represent a simple method to help tackle non-intentional non-adherence and to help patients better fulfill their treatment [ 12 , 13 , 14 , 15 , 16 ].

A Dose Administration Aid Service (DAAS) consists of repackaging solid oral medication by a healthcare provider, mostly in a community or hospital pharmacy, in order to help patients manage their polymedication [ 10 , 17 ]. DAA are the devices that allow medications to be organized and stored in compartments according to a patient’s dosing schedule. DAA can be grouped into three different categories: reusable multicompartment adherence aids (so-called pillboxes or manually filled dosettes); manual or automated blister packs; and sachet systems [ 10 , 18 ].

Reusable multicompartment adherence aids exist in various shapes and sizes. However, the most commonly used is the 7-day format, with four subcompartments for different times of the day. They can be self-administered by the patient or filled by the caregiver or pharmacy staff, which constitute major advantages, along with its reusability. Nevertheless, there are also some significant disadvantages related to hygiene, stability of the deblistered tablets, and accuracy of manually filled aids [ 10 ].

In manual blister packs, it is a pharmacist who manually distributes the medication into a securely sealed blister pack (or it is an automated system which distributes the medication automatically, in the case of automated blister packs), therefore protecting the medication until administration time. This type of DAA is widely used around the world and the corresponding service is remunerated in several countries. Their manual production is easy and affordable for every pharmacy, though they require the implementation of rigorous quality controls before dispensing to the patient. They also have a reminder function as they allow the patient to visualize the pills that need to be taken and the ones that were already taken [ 10 ].

With sachet systems, medication for a particular date and time of the day are packed in an individual sachet, labelled with the date and time, the medicine details, and the patient’s name. They are rolled up in chronological order and prepared using an automated packing technology. Community pharmacies either outsource this service to a large-scale packing facility, or have installed technology to enable onsite packing, despite the considerable investment associated with the latter [ 19 ]. This service is mainly used for institutionalized patients and when a greater number of patients is considered. In contrast to multi-drug punch cards, sachet systems do not allow for a visual control of the taken medication, and patients (especially ambulatory) need good instructions in order to follow the proper sequence of the sachets [ 10 ].

The most recent systematic reviews admit the possibility of a positive impact of a DAAS on medication adherence, drug safety, clinical outcomes, and reduction of waste. However, these studies also highlight the fact that the existing literature is still limited and susceptible to bias [ 20 , 21 , 22 ].

The aim of this study is, therefore, to characterize DAAS implementation in Portugal and understand the perceptions of pharmacists and/or owners of community pharmacies regarding the impact of DAAS, preferred methodology types, and State contribution.

2. Materials and Methods

2.1. study design.

The study used qualitative research and semi-structured interviews to access the perceptions and experiences of pharmacists and/or owners of community pharmacies regarding DAAS ( Appendix B ). Creswell (2013) [ 23 ] suggests that qualitative research is preferred to quantitative research when health science researchers seek to (a) share individual stories, (b) write in a literary, flexible style, (c) understand the context or setting of issues, (d) explain mechanisms or linkages in causal theories, (e) develop theories, and (f) when traditional quantitative statistical analyses do not fit the problem at hand. In particular, the study used qualitative description, which is considered to be especially amenable to health environments research because it provides factual responses to questions about how people feel about a particular issue, what reasons they have for using particular services or features, and the factors that facilitate or hinder use [ 24 , 25 , 26 ].

2.2. Participants

Participants in this study were 18 pharmacists, that were either technical directors, pharmacists responsible for the service, and/or owners of community pharmacies, who were recruited through convenience sampling. In Portugal, a technical director is the pharmacist responsible for all acts (pharmaceutical services and other) performed at a specific pharmacy. Criteria for study participation were the provision of DAAS for at least six months and having at least one user of this service at the time of data collection.

The sample of community pharmacies was obtained in two ways: (i) through Google ® search, using the keywords “pharmacy” and “dose administration aid service”; (ii) via contact with pharmaceutical groups established in Portugal, which provided a list of community pharmacies that met the requirements and were interested in participating in the study. This process resulted in the identification of 433 community pharmacies, which were approached through direct contact via email and/or telephone. After being contacted twice, a reply was received from 25 pharmacies of which only 18 agreed to participate. The remaining seven pharmacies refused to participate for not having the service available at the time. The geographical distribution of the 18 pharmacies is presented in Figure 1 , encompassing 11 of the 18 districts of mainland Portugal.

Geographic distribution of the community pharmacies.

The pharmacists (technical directors or those responsible for the service) and/or owners of the 18 community pharmacies were interviewed by one of the researchers (AV). The participants’ profile is provided in Table 1 .

Participants’ characterization.

All participants provided their written informed consent to participate in this study and for the publication of data included in this article. The information provided in the consent form explained the objectives of the study, the voluntary nature of participation, the possibility to withdraw from the study at any time, the materials, methods, and procedure to collect and analyze the data, and the anonymity and privacy statements. Ethical review and approval were obtained from the Ethics Committee of the University of Beira Interior (process no. CE-UBI-Pj-2021-004:ID530).

2.3. Data Collection

Data were collected through semi-structured, one-on-one interviews with the 18 pharmacists and/or owners of community pharmacies between 16 March 2021 and 7 July 2021. Interviews took around 40 min and were conducted via videoconference in the participants’ workspaces. All interviews were carried out by one of the researchers (AV) following a guide ( Appendix A ) that was developed based on the phenomenon of interest and drawn from relevant literature [ 27 , 28 , 29 ]. The interview guide included close-ended questions, which covered, for instance, the number of years the pharmacy had been providing DAAS, the number of people using the service, the methodologies available, or the average cost of the service. Open-ended questions were also used to encourage participants to express their personal opinions regarding their preferred methodology or the impact of the service on user safety, waste reduction, and therapy adherence.

The guide was tested for face and content validity by a panel of experts [ 30 ], which included 2 pharmacists familiar with the research subject. The panel assessed the appropriateness and comprehensiveness of the interview guide contents in relation to the aims and the subjects of the study. Question items were also reviewed for readability, clarity, and comprehensiveness [ 31 ]. The experts’ comments were discussed and analyzed critically by two researchers involved in this study (AV and OL) and changes for improvement were negotiated. These included reformulating some items for greater clarity, re-ordering, and adding more questions. To ensure understandability of the questions during the interviews, the participants were given the freedom to raise concerns, skip any question, or even withdraw from the interview at any time during the study without giving reasons. Furthermore, if the question was not properly comprehended, the interviewer explained it in further detail or using alternate expressions.

Considering the ethical and legal issues involved in collecting and retaining visual or audio-recorded data, only field notes were made during and immediately after the interviews. To ensure accuracy and comprehensiveness of the data, the researcher conducting the interviews (AV) made sure to use factual and objective terms, include specific quotes, and refrain from adding his own inferences and beliefs to the interview notes to minimize bias. Furthermore, caution was also taken to ensure that the notes translated participants’ perceptions or opinions by further inquiring along the views they presented. After each interview, field notes were examined and checked for accuracy, legibility, completeness, and clarity by two researchers (AV and OL).

2.4. Data Analysis

Data collected from the field notes were treated using content analysis, a technique commonly used in qualitative research to systematically and objectively analyze words or phrases in text documents. Hsieh and Shannon (2005) present three types of content analysis, any of which could be used in a qualitative descriptive study [ 32 ]. Conventional con-tent analysis is used in studies that aim to describe a phenomenon where existing research and theory are limited; directed content analysis is used in studies where existing theory or research exists; while summative content analysis is used to quantify and interpret words in context, exploring their usage. In this study, conventional content analysis was preferred to the other types of content analysis, considering the dearth of research on DAAS in the Portuguese context and the possibility of gaining direct information from the study participants.

Data analysis started with reading all field notes repeatedly to gain familiarity with the content and obtain a sense of the whole. Then, data were read word by word to derive codes. Firstly, the exact words from the text that appeared to capture key thoughts or concepts related to the participants’ perceptions and experiences were highlighted. Then, notes were taken to document first impressions. As this process continued, an initial coding scheme was created by assigning labels for codes that were reflective of more than one key thought. Codes were then sorted into categories and, later, into subcategories for a more comprehensive analysis. At this stage, a tree diagram was developed to help organize these categories into a hierarchical structure ( Figure 2 ). Exemplars for each category and subcategory were identified to facilitate reporting of the findings. To provide guidance during the reporting of this study, the consolidated criteria for reporting qualitative research (COREQ) checklist ( Appendix B ) was used.

Tree diagram of categories and subcategories.

It is worth mentioning that qualitative content analysis was complemented with statistical analysis, whenever appropriate. This is a common strategy in qualitative descriptive studies if they aim to more adequately or fully describe the participants or phenomenon of interest [ 24 ]. In the case of this study, descriptive quantitative analysis was used to allow for a more thorough characterization of DAAS in Portugal.

2.5. Trustworthiness and Reflexivity

The criteria of credibility, dependability, transferability, and confirmability were used to assess the trustworthiness of the data [ 33 ]. Credibility was ensured through periodical peer debriefing between the researchers to discuss data analysis and findings. To ensure dependability, two researchers (AV and ML) discussed the process of data analysis and codes, making appropriate adjustments as necessary to establish consensus and guarantee consistency. Furthermore, an audit trail of the research process was maintained through detailed documentation of the coding meeting notes, the recruitment protocol, and all field notes taken during and after the interviews. Transferability and rigor were achieved through data obtained from interviews with participants from 18 community pharmacies representing 11 of the 18 districts of Portugal, which allowed for a diverse range of perspectives on the phenomenon under study. To facilitate transferability, the research context, participants, and settings are described in a rich manner. Confirmability was ensured through a detailed methodological description and through reflexivity [ 34 ], meaning that the researchers were aware of their background and position and how these could influence the research process.

Our research team consisted of one male researcher (AV), a master’s student in Medi-cine (AV), and three female researchers (BM, ML, and OL), two non-practicing pharmacists (AV, OL), and a qualitative researcher (ML). Both AV and OL (an assistant professor) have interests in improving medication adherence. AV had taken a graduate study course on qualitative and quantitative research methods, ML has over 15 years of experience as a qualitative researcher, and OL has experience in conducting qualitative research. Throughout the research process, team members discussed their personal views on DAAS. All of the researchers had only a theoretical understanding of DAAS, never having advised or provided the service in a community pharmacy environment. AV conducted the interviews. After every interview, AV and OL appraised the interview, the appropriateness of the questions, and discussed the level of comfort of participants in answering the interview questions.

3.1. Characterization of the DAAS

Table 2 gives an overview of DAAS’ characteristics available in each pharmacy. All pharmacies use manual blister packs, except for one, which uses only automated blister packs ( Figure 3 ). In two pharmacies, automatized sachet systems coexist with manual blister packs. The majority of the pharmacies (16 out of 18) provide DAAS on a weekly regimen. It is important to note that therapeutic reconciliation is a crucial part of the service in all the pharmacies, being mandatory at the beginning of the process and whenever pharmacists deem it necessary.

Methodologies provided. wBP: weekly blister pack; mBP: monthly blister pack; bBP: biweekly blister pack; wSS: weekly sachet system; mSS: monthly sachet system; wAMD: weekly automated blister pack.

Overview of DAAS’ characterization.

ABP: automated blister packs; BP: manual blister packs; DK: do not know; N/A: non-applicable; NR: did not answer; SS: sachet system; * not considering humans resources’ cost.

DAAS has been provided on average for 4.8 ± 2.77 years (median 5 years). The maximum value recorded was 10 years and the minimum was half a year ( Figure 4 ).

Number of years of service provision.

At the time the interviews were made, pharmacies provided the service on average to 11 ± 18.46 ambulatory users and 95 ± 240.66 institutionalized users, showing a high variability ( Figure 5 ). Although data suggest an apparent trend for DAAS to be a service provided mainly to institutionalized users, it is important to emphasize that only half of the pharmacies provide DAAS in this setting and, except for one, all have at least one ambulatory user. It is also worth mentioning that pharmacy C, despite not having institutionalized users at the time of the interview, has previously provided services in this type of facility.

Number of DAAS current users (ambulatory and institutionalized).

Costs for the service are summarized in Figure 6 . For users, the cost is on average EUR 12.91 ± 4.89 per month. The maximum reported value was EUR 20 per month and the minimum EUR 7.5 per month. The average cost for pharmacies was EUR 8.74 per month, considering all the expenses, as reported by 5 out of 18 participants (#2, #3, #7, #13, and #17). Three participants did not know the data to properly answer this question (#4, #10, and #11), one did not want to answer (#15), and eight did not know how to quantify the human resources’ costs (#5, #6, #8, #9, #12, #14, #16, and #18). In pharmacy A, the service is provided as part of an established contract for dispensing medicines. Pharmacy P offers the service cost-free.

DAAS’ cost per month for users and the pharmacies. NR: did not answer; DN: do not know; * not considering human resources’ cost.

3.2. Preferred Methodology

This category captures participants’ perceptions of preferred methodologies and the reasons behind them. Preferred methodologies are those perceived as the best methodologies despite being currently applicable or not.

Although manual blister packs are the most frequently provided methodology, the majority of participants (10 out of 18) believe that an automated methodology is best in terms of convenience because of its easiness of use, and lower cost of preparation ( Figure 7 ). Participant #17 also mentioned the easiness of the expansion of the service as an advantage. However, since “the investment costs are too high for the actual low number of users the service has, it is not practicable”. Participant #16 also added another reason for automation not being feasible, which is the “gratuitousness of the service”. Participant #18 justified the automated choice because “they did not know others”. Six participants preferred the manual methodology because of its easiness of use and one participant (#5) because “they did not know others”. In terms of frequency, a weekly methodology is preferred (13 out of 18) due to a “tighter and more rigorous monitoring by the pharmacist”. Four participants preferred monthly preparation because it was logistically easier for them. One participant (#7) did not commit with a specific answer and mentioned frequency was variable, being influenced by factors such as the “users’ cognitive ability” and “how easy it is for them to go to the pharmacy”.

Preferred methodologies.

3.3. Impact on Safety

In terms of safety, it is unanimous that DAAS improves medication safety amongst users since it “prevents errors” such as “overdose”, “forgetfulness”, “incorrect drug use”, or “wrong time or administration mode”. Participant #9 explored one of the reasons for some of these issues: “There’s a lot of confusion about generics or what is the active substance of each medication or what it’s used for”. Another participant (#10) gave the example of a patient who “stopped having neurologic complications due to medication errors after enrolling in the service”. Participants also added that “pharmaceutical monitoring is a safety net” since there is a therapeutic reconciliation process throughout the service. As participant #6 explained: “Considering that the majority of DAAS’ users are polymedicated, it is understandable that there’s an increase in terms of medication errors and side effects. So, the therapeutic reconciliation made by the pharmacist along with the therapeutic reconciliation made by different prescribers helps to achieve greater safety”. The same idea was stated by participant #10: “The initial ‘medication cleaning’ in DAAS prevents medication errors that users tend to commit”.

There are other reasons that explain the impact of DAAS on safety. For instance, as expressed by participant #9, “the monitoring of important parameters such as blood pressure for a person who is taking antihypertensives, for example, is included in DAAS”. Participant #12 alluded to the fact that “Even in terms of medications’ safety there is an improvement since storage and conservation conditions are guaranteed in a tighter way”. Participants also discussed the “better articulation between the attending physician and the pharmacist”, which can be seen as part of an integrated approach to medical care. As participant #2 explained, there is an “inverse feedback circuit from the pharmacy to the medical doctor about the actual reality of everyday users which allows to complement the care doctors provide, who very often feel they lack time for a thorough evaluation”. Participant #12 added “We discover more medication errors that patients are committing, which really helps in terms of prevention”. Participant #17 summed up the impact on safety and the advantages of the better articulation with the attending physician: “DAAS assures that the patient is not making mistakes alongside their medication (like overdose), that they do not forget to take their medication, that the patient has a qualified professional watchful to every possible medication’s interactions or side effects as well as decompensation of parameters and the arising of different symptoms related to a new health condition. This leads to better care since there’s an anticipated referral to the attending physician on a routine basis or in urgent episodes”.

3.4. Impact on Therapeutic Adherence

All participants were unanimous in stating that DAAS improves therapeutic adherence. One participant even mentioned that they “do not know of a method as good as DAAS to improve therapeutic adherence” (#2). Participant #6 added “I feel it has a significant impact because I can verify in my daily practice that users achieve better health results since there is a greater therapeutic adherence”. Even though there is no reliable data to compare adherence before and after starting the service, DAAS is considered to be a “very significative improvement” and one participant (#2) shared a 97% adherence rate among users. Some pharmacies save an adherence record based on the returned blister packs, which is very useful, however, “it is necessary to insist that the users bring the blister pack back so that adherence can be properly recorded. When patients bring the blister pack back we can check the therapeutic adherence which is very useful to notify caregivers or even medical doctors in some rare cases” (#4). Participant #14 helped to understand why it is often difficult to establish a link with the attending physician: “Although an effective articulation between pharmacists and doctors is crucial to monitor therapeutic adherence, it is not done regularly because the whole system is not designed to make it happen on a routine basis”.

The reasons why therapeutic adherence is improved were also advanced by participant #17, who explained that these are related to the “feeling of security the service provides” and “the commitment that is established”. Nevertheless, according to participant #3, “the system is not perfect because the user needs to know which day it is to know how to comply. However, in those cases, we make sure they do not forget by sending a notification”.

3.5. Impact on Waste

Considering the impact that DAAS has on waste, this is the only topic where there was no unanimity among the participants. The majority (15 out of 18) consider that in terms of medication waste, there is a reduction because the stock control is made by the pharmacy, reducing the accumulation and excessive consumption of medicines. Consequently, “patients do not buy every medicine the prescription has or, at least, in unnecessary amounts, creating pharmacies at home” (participants #10, #11, and #18). Participant #10 added “There is a handover of the medication management to the pharmacist allowing health gains and also financial savings for the State by waste reduction”. Participant #12 gave a personal example: “We have a patient who had 38 packages of medication at home when they first started the service, this was clearly a problem”. Additionally, 10 out of 18 also mention the indirect costs’ effect because the improvement in therapeutic adherence and safety leads to a decrease in health services’ costs. Participant #12 mentioned “The core of this indirect costs’ effect is simply the investment on prevention this service provides”. Nevertheless, participant #11 stated that “Although therapeutic adherence and prevention of errors diminish healthcare costs, it is difficult to quantify gains in waste, so they may go unnoticed”. Contrary to the majority’s opinion, two participants (#1 and #8) did not consider DAAS to have an impact on waste reduction. One participant (#6) did not provide a definite answer, explaining that they did not have the time to analyze the available data.

3.6. State Contribution

State contribution refers to all forms of money given, loaned, advanced, or reimbursed to the patients or the pharmacies in order to cover the cost of the service, and make it affordable. Regarding participants’ opinions about the State’s contribution to DAAS and the reasons behind it, all participants believe the State should contribute financially to some degree, so that patients, especially those with a handicap on therapeutic adherence or taking multiple drugs, can have access to this type of service. Participant #12 mentioned “It makes total sense, especially in those cases where there are adherence problems identified by doctors”. The reasons behind this opinion are based on the benefits DAAS has both for users (the impact assessment participants mentioned) and to the State. The State can save financial resources via the reduction of direct costs, as the service leads to the reduction of waste of reimbursed medicines, and indirect costs, because DAAS induces fewer complications of non-compliance to therapy and medication errors. Participant #6 summed this up in a very explanatory way: “The State contribution makes total sense, since the improvement on therapeutic adherence leads to better pathology control and decreases emergency visits and hospitalizations”. Furthermore, DAAS can promote an environmentally responsible disposal of waste: “It is important to note that by putting all empty packages into Valormed containers (an entity which manages medicines waste) we are also contributing to environmental sustainability, as we will be also reducing the health problems related to soil and water pollution by the chemicals from those medications” (#6). As stated by participant #17: “There are many people with medication managing difficulties who would benefit from this service and are unable to adhere for economic reasons. From a public health point of view, it would have a positive impact on the global improvement of the population’s health and quality of life due to increased adherence and monitoring of the therapy. In the long run it would translate into savings, as awareness about the correct taking of medication would avoid the reimbursement of thousands of boxes of medications that are left aside due to non-adherence”.

One participant (#2) also mentioned that with the State contribution, it would be possible to “stimulate the service provision”, including on institutionalized facilities that “sometimes cannot support that additional cost”. Furthermore, to make it work, participants said that “there is a need of more scientific data on DAAS’ advantages so that the State can see its true potential” (#2), “it should not be put at a maximum retail price as it happens on medicines because it excessively limits the market” (#4), and finally, “there needs to be a strong link between medical doctors and pharmacists” (participants #7, #10, and #14). In this topic, some ideas were suggested to increase the cooperation between pharmacists and attending physicians: “giving the pharmacists access to the full prescribed medication record of each patient and conversely giving doctors the possibility to navigate through the pharmacy records on therapeutic adherence, for example” (#2); “a practical system to notify the attending physician on side effects, interactions, and chronic therapeutic renewal alerts” (#1).

Participants #2 and #3 mentioned the need for quality assurance of DAAS: “Create uniform guidelines for quality assurance” (#2); “There must be a set of prerequisites concerning the provision of DAAS and the required competencies of the institutions that provide it” (#3). Participant #11 added: “Nowadays, local stakeholders’ contribution is being considered… given the lack of financial resources available it is difficult to have a centralized system. It is easier for city halls to implement such a system, but this might lead to inequalities between people living in different towns and cities in the same country”.

4. Discussion

This study aimed to characterize DAAS implementation in Portugal and understand the perceptions of technical directors, pharmacists, and/or owners of community pharmacies regarding the impact of DAAS, preferred methodology types, and State contribution.

DAAS is a recently provided service, which has been available on average for 4.8 years. It is important to stress that Portuguese legislation on DAAS was only passed in 2018 [ 35 ]. Following this publication, the Community Pharmacy College of the Ordem dos Farmacêuticos issued norms for service provision [ 36 ].The service is available for institutionalized and ambulatory users alike, with numbers served per pharmacy being highly variable.

In terms of DAAS characterization, a weekly manual blister pack is the most frequent methodology provided. The calculated user’s average cost per month was EUR 12.91, way above the literature reported cost the users are willing to pay for such a service (EUR 5 per month) [ 37 ]. This fact can be one of the reasons patients do not use this service, despite its advantages. The pharmacy’s calculated average cost was EUR 8.74 per month, reflecting an estimated profit of EUR 4.17 per month per user. However, it is important to emphasize that this data analysis is too simplistic, as estimation of pharmacy costs was only possible for some of the pharmacies. A previous study estimated the provider’s cost at EUR 6.76 per month [ 37 ], which is similar to the value obtained through the interviews. Furthermore, in Portugal, manufacturers supply medicines in blister packs, rather than bottles or tubs. In order to dispense into the devices, transfer of medication from blister packs increases the fill-times, and as a consequence, service cost.

In terms of the preferred methodology for service provision, weekly and automated were the top choices. However, high investment costs and a low number of current users make automation unprofitable, and hence, seldom available. It is interesting to note that pharmacies with a higher number of users, above 65, start providing an automated method in addition to the manual one. A weekly methodology is preferred because follow-up by the pharmacist is tighter and more rigorous.

Considering the impact on safety, the participants were unanimous in stating that DAAS has a positive impact, especially by reducing medication errors (overdose, forgetfulness, incorrect medicine, or wrong time and mode of administration), despite lack of objective data. This result is similar to unpublished data available for Portugal and abroad, namely from a randomized controlled trial in the United States [ 38 ], and the systematic review performed by Sinnemaki et al. [ 21 ].

The impact on therapeutic adherence is believed to be positive, but once again the participants mention the lack of time to analyze available data.

Regarding the impact on waste, the majority of the participants considered that there was a reduction of waste because the stock control is made by the pharmacy and prevents accumulation and abuse of medicines. There is also the indirect costs’ effect, as controlled patients tend to recur less to healthcare services. The most recent Portuguese study on medication waste dates back to 2007 [ 39 ]. At that time, the global waste identified in pharmaceutical units was 21.7% of the prescribed amount. About half (9.7%) was due to inadequacy of the size of the packaging(s) to the treatment instituted, and the other half (10.2%) to the non-adherence of patients to therapy [ 39 ].

Several systematic reviews on DAAS and DAA admit the possibility of positive effects on these three categories, and even a positive impact in clinical outcomes, although the quality of the available studies remains poor [ 20 , 21 , 22 ]. The study by Watson et al. stressed that organization devices may help unintentional medication non-adherence and could improve health outcomes [ 20 ]. This benefit was, however, not reflected by all studies.

As well as the potential benefits, DAAS may also introduce risks. Foremost, it introduces an additional step in the dispensing process when the pharmacist transfers prescribed medications into the DAA. Moreover, it is important to note that not all medicine can be packed in DAA, such as liquid or semi-solid formulations, medicines that degrade through air or light contact, and emergency medication. Even for solid medication, there is a paucity of data on the stability of chronic medications in DAA [ 40 ].

4.1. Limitations

This study is not without limitations. Firstly, considering the estimated population size, the sample size is low. According to data obtained from the Ordem dos Farmacêuticos (National Association of Pharmacists), around 10% of all pharmacies in Portugal provide the service ( n = 366). Moreover, taking into account the results of a literature review study that provided a systematic analysis of qualitative health research from 2003 to 2017, it was considered that 20 interviews would be enough to reach saturation [ 41 ]. The current global pandemic was probably a factor that affected the high rate of non-response. Furthermore, study participants were sampled using the convenience sampling approach. Therefore, the study may not fully represent the wide range of participants’ perceptions.

Secondly, there is also a possibility of a positive bias concerning DAAS’ impact since all the participants worked in pharmacies where this service was available, and thus they may want to emphasize DAAS’ positive qualities and benefits.

Finally, our interview guide was not pilot-tested before the beginning of the study and participants did not have an opportunity to go through the transcripts to validate what was said during the interviews. Additionally, they did not have the opportunity to analyze the data to provide their feedback on the appropriateness of the codes in capturing their perceptions. Although the field notes were not sent to the participants, we did send the manuscript for checking before submission.

4.2. Implications for Research and Practice

The participants indicated multiple benefits for DAAS, related to both patients and the healthcare system.

Our findings suggest that it is important to further research DAAS’ impact on safety, adherence, and waste, as there is still a lack of reliable data and good-quality studies.

It is also crucial to explore the reasons behind the low rate of implementation of this service among community pharmacies and the reasons behind the lack of users’ adherence to this type of service.

Based on the participants’ experiences, the following aspects can be highlighted:

• DAAS can have a positive impact on safety, adherence, and waste, especially for patients with complicated medication schedules, on multiple drugs, or with some level of cognitive impairment;
• DAAS is useful both for ambulatory users and institutionalized users;
• There is a need to make the service affordable for users, while not too cumbersome for pharmacies.

Acknowledgments

We gratefully acknowledge the study participants and the pharmacists within the Associação Nacional de Farmácias who provided national data on DAAS.

Appendix A. Interview Guide

• For how long has the Dose Administration Aid Service (DAAS) been available?
• How many users currently use the DAAS in your pharmacy?
• What methodology(ies) are available?
• Which of the methodologies do you consider to be the best?
• What is the average cost per month for users?
• What is the average cost per user per month for the pharmacy?
• Do you think that it makes sense to have a State contribution?
• Is therapeutic reconciliation associated with DAAS?
• What impact does this system have on user safety, bearing in mind that it is possible to associate therapy reconciliation?
• What impact does DAAS have on reducing waste at this time?
• What impact do you feel DAAS has on therapy adherence?
• The legal framework in which this service is inserted follows an after-sales service. What do you think about making this pre-sale, that is, within a unitary distribution system?
• With this system, would it be possible to reduce medicine waste?
• Why did your establishment not participate in the experimental regime introduced by the government in 2010?

Appendix B. COREQ Checklist

Consolidated criteria for reporting qualitative research (COREQ) checklist.

Author Contributions

Conceptualization, A.V. and O.L.; methodology, A.V. and O.L.; formal analysis, A.V. and M.L.; investigation, A.V. and B.M.; data curation, A.V.; writing—original draft preparation, A.V., B.M., M.L. and O.L.; writing—review and editing, M.L. and O.L.; supervision, O.L. All authors have read and agreed to the published version of the manuscript.

This research received no external funding.

Institutional Review Board Statement

The study was conducted according to the guidelines of the Declaration of Helsinki and approved by the Ethics Commission of the University of Beira Interior (process no. CE-UBI-Pj-2021-004:ID530 and 9 February 2021).

Informed Consent Statement

Informed consent was obtained from all subjects involved in the study.

Data Availability Statement

Conflicts of interest.

The authors declare no conflict of interest.

Publisher’s Note: MDPI stays neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Pharmacy Infoline

Health, Science, Technology News, Pharmcy notes

20057 CMP Community Pharmacy & Management Practical D Pharm

Community pharmacy & management practical d pharm.

Handling of prescriptions with professional standards, reviewing prescriptions, checking for legal compliance and completeness (minimum 5)

Identification of drug-drug interactions in the prescription and follow-up actions (minimum 2)

Preparation of dispensing labels and auxiliary labels for the prescribed medications (minimum 5)

Providing the following health screening services for monitoring patients/detecting new patients (one experiment for each activity) :

• Blood Pressure Recording,
• Capillary Blood Glucose Monitoring,
• Lung function assessment using Peak Flow Meter and incentive spirometer,
• Recording capillary oxygen level using Pulse Oximeter,
• BMI measurement

Providing counselling to simulated patients for the following chronic diseases/disorders including education on the use of devices such as insulin pen, inhalers, spacers, nebulizers, etc. where appropriate (one experiment for each disease) :

• Type 2 Diabetes Mellitus,
• Primary Hypertension ,
• Hyperlipidaemia,
• Rheumatoid Arthritis

Providing counselling to simulated patients for the following minor ailments (any three):

• GI disturbances (Nausea, Vomiting, Dyspepsia, diarrhoea, constipation),
• Worm infestations ,
• Upper Respiratory Tract infections ,
• Skin infections ,
• Oral and dental disorders .

Appropriate handling of dummy dosage forms with correct administration techniques –

• Oral liquids with measuring cup/cap/dropper,
• Nasal drops,
• Insulin pen,
• Nebulizers,
• Different types of tablets,
• Suppositories

Use of Community Pharmacy Software and digital health tools

Assignments

The students shall be asked to submit written assignments on the following topics (One assignment per student per sessional period. i.e., a minimum of THREE assignments per student)

SOPs for various activities in Community Pharmacy (as discussed in Theory and Practical)

List out the various abbreviations, short forms used in prescriptions and their interpretation

Patient Information Leaflet for a given chronic disease/disorder

Patient Information Leaflet for prescription/non-prescription medicines

Preparation of window/shelf display materials for the model community pharmacy

Overview of Software available for retail pharmacy management including billing, inventory, etc.

Dosage/Medication Reminder Aids

Overview on the operations and marketing strategies of various online pharmacies

Overview on the common fixed dose combinations

Overview on the medications requiring special storage conditions

Role of Community Pharmacists in preventing Antimicrobial Resistance

Jan Aushadhi and other Generic Medicine initiatives in India

Global Overview of Online Pharmacies

Community Pharmacy Practice Standards: Global Vs. Indian Scenario

Overview of Pharmacy associations in India

Field Visit

The students shall be taken in groups to visit community pharmacies and medicine distributors to understand and witness the professional activities of the community pharmacists, and supply chain logistics. Individual reports from each student on their learning experience from the field visit shall be submitted.

F Y D Pharm & S Y D Pharm Notes, Books, Syllabus, PDF, Videos

• 20055 SPP Social Pharmacy Practical D Pharm
• Overview of Vaccines, Vaccine types
• 2.5 Community Pharmacy Pharm D Syllabus, Notes, PDF, Books, Downloads, MCQ
• 20051 PHP Pharmaceutics Practical D Pharm
• 20060 HCP Hospital & Clinical Pharmacy Practical D Pharm

You may have missed

Regenerative medicine: rejuvenating the body’s natural healing potential, a legacy of loss: the contaminated blood scandal and haemophilia, percutaneous aortic valve replacement (tavr): a minimally invasive option for heart valve disease, severe combined immunodeficiency (scid).

COMMUNITY PHARMACY AND MANAGEMENT – PRACTICAL

Course Code: ER20-22P

75 Hours (3 Hours/week)

Scope: The course is designed to train the students and improve professional skills to provide various pharmaceuticalcare services in community pharmacy.

Course Objectives: This course will train the students in the following

1. Professional handling and filling prescriptions

2. Patient counselling on diseases and minor ailments

3. Patient counselling on prescription and / or non-prescription medicines

4. Preparation of counselling materials such as patient information leaflets

5. Performing basic health screening tests

Course Outcomes: Upon successful completion of this course, the students will be able to

1. Handle and fill prescriptions in a professional manner

2. Counsel patients on various diseases and minor ailments

3. Counsel patients on prescription and or non-prescription medicines

4. Design and prepare patient information leaflets

5. Perform basic health screening tests

Note: The following practicals shall be carried out in the model community pharmacy with appropriate simulated scenarios and materials. Students shall be trained through role plays wherever necessary. The activities of the students shall be assessed / evaluated using a structured objective assessment form.

Handling of prescriptions with professional standards, reviewing prescriptions, checking for legal compliance and completeness (minimum 5)

Identification of drug-drug interactions in the prescription and follow-up actions (minimum 2)

Preparation of dispensing labels and auxiliary labels for the prescribed medications (minimum 5)

Providing the following health screening services for monitoring patients / detecting new patients (one experiment for each activity)

Blood Pressure Recording, Capillary Blood Glucose Monitoring, Lung function assessment using Peak Flow Meter and incentive spirometer, recording capillary oxygen level using Pulse Oximeter, BMI measurement

Providing counselling to simulated patients for the following chronic diseases / disorders including education on the use of devices such as insulin pen, inhalers, spacers, nebulizers, etc. where appropriate (one experiment for each disease)

Type 2 Diabetes Mellitus, Primary Hypertension, Asthma, Hyperlipidaemia, Rheumatoid Arthritis

Providing counselling to simulated patients for the following minor ailments (any three)

Headache, GI disturbances (Nausea, Vomiting, Dyspepsia, diarrhea, constipation), Worm infestations, Pyrexia, Upper Respiratory Tract infections, Skin infections, Oral and dental disorders.

Appropriate handling of dummy dosage forms with correct administration techniques - oral liquids with measuring cup/cap/dropper, Eye Drops, Inhalers, Nasal drops, Insulin pen, nebulizers, different types of tablets, patches, enemas, suppositories

Use of Community Pharmacy Software and digital health tools

Assignments

The students shall be asked to submit written assignments on the following topics (One assignment per student per sessional period. i.e., a minimum of THREE assignments per student)

SOPs for various activities in Community Pharmacy (as discussed in Theory and Practical)

List out the various abbreviations, short forms used in prescriptions and their interpretation

Patient Information Leaflet for a given chronic disease / disorder

Patient Information Leaflet for prescription / non-prescription medicines

Preparation of window / shelf display materials for the model community pharmacy

Overview of Software available for retail pharmacy management including billing, inventory, etc.

Dosage / Medication Reminder Aids

Overview on the operations and marketing strategies of various online pharmacies

Overview on the common fixed dose combinations

Overview on the medications requiring special storage conditions

Role of Community Pharmacists in preventing Antimicrobial Resistance

Jan Aushadhi and other Generic Medicine initiatives in India

Global Overview of Online Pharmacies

Community Pharmacy Practice Standards: Global Vs. Indian Scenario

Overview of pharmacy associations in India

Field Visit:

The students shall be taken in groups to visit community pharmacies and medicine distributors to understand and witness the professional activities of the community pharmacists, and supply chain logistics. Individual reports from each student on their learning experience from the field visit shall be submitted.

If you are a member of the public looking to access our rapid self-assessment tool, AskSARA, please contact your local authority to access this service.

If you are a local authority or organisation wishing to enquire about obtaining a license for your residents, please contact us at [email protected], where we will be happy to assist.

To see a list of current Local Authority & HSCP Licensees, click the button below.

Medication alarms and reminders

This section includes devices to alert or remind you to take your medication.

Alarms with multiple daily alarms allow the setting of multiple daily alarms but do not store pills. They could be set to sound an alarm to prompt the user to take their medication at different times, for example, morning and evening doses.

Medication reminder apps can be downloaded to compatible smart phones and are designed to give a reminder when your medication is due. You, or someone you know have to set the dosage times, and names of the medication before the reminders will work. Some give an audible reminder, others just a visual reminder when you check the screen.

Introduction

Provision of equipment, private purchase, planning for a safer home, finding solutions, ethical implications of equipment, day/date and time orientation, prompting devices, taking medicines, pill or dosette boxes, dispensing pill boxes, pill dispensers with prompts, telecare enabled pill dispensers, smartphone or tablet apps, safety in the home, smoke and heat alarms, telecare smoke alarm, carbon monoxide alarms, cooking and gas alarms, gas isolator switches, alternative cooking appliances, temperature, cold room temperature, walking about, motion sensors - systems to sound an alert if an individual leaves or enters a certain area, sensors detecting movement from a bed or chair, sensors detecting door opening, personal locators for use outside the home, home access and security, intercom systems, mobile phones, pendants, pagers and autodialler alarms, pendant alarms, autodialler alarms, mobile phones with emergency buttons, emergency medical and personal information.

There are times when many of us momentarily lose track of which day it is. However, if a person is losing track of the days and missing appointments, or not paying bills on time, this is an indication of a significant problem with their memory. There may be other signs such as forgetting names of people in everyday contact, regularly losing items where this was not a problem in the past, or a significant loss of weight. These things can be very frustrating and cause anxiety.

If you feel that this is a problem or the situation is getting worse, contact your GP, particularly if there are feelings of agitation, anxiety or extreme irritability. A GP can offer treatment advice, information and/or referral to other services depending upon your wishes and circumstances. You can search for your nearest GP on the NHS website.

Most local authorities have a community equipment service which is used by both health and social services. Equipment is generally issued based on an assessment of your need. There may also be eligibility criteria. For simple bits of equipment you may be interviewed over the telephone. For more complex equipment an assessor will need to visit your home. They may ask you to try an activity to see how and why you are finding it difficult. This will indicate to them the most appropriate equipment to meet your needs. The assessor should also be able to provide you with relevant information and advice, or direct you to suitable organisations/services in your area.

Telecare uses technology in the home to monitor and support individuals remotely. This might be a fall alarm, a sensor that monitors the home environment, such as a gas detector, or a personal locator for those for whom disorientation is a problem. They are connected to a central monitoring centre, or a trusted individual, who can respond when needed. Local authorities usually partner with a specialist telecare company to provide a service in their area. Sometimes it is free, sometimes there is an initial cost and/or a weekly charge. Local authorities may meet the cost if you would find this difficult

You may also see the term mCare or mHealth which stands for mobile care/health. This uses mobile phones to access telecare and telehealth.

You will need to contact your local authority and ask for information on their equipment and telecare services. If your local authority assess you as requiring a service they will also complete a financial assessment to assess the level of any contribution you may be required to make.

In many areas a range of the simple aids to daily living may be available on prescription, issued by the assessor. These may include a small range of telecare equipment. If you receive a prescription for one of these items you can take it to a local accredited retailer, which may be a local pharmacy, who will provide you with the item. You can pay extra for an alternative item, so long as it does what the specific item prescribed would do. Your choice may offer extra features, or perhaps you prefer its appearance.

If you decide to buy equipment privately it is best to try and compare the different ranges first. You may have an equipment demonstration centre near you where you can visit to view and try out ranges of equipment. You will receive impartial advice to help choose appropriately. However, not all centres display telecare systems. You will need to contact your nearest centre to find out what they have and to book an appointment. 

Be cautious of sales people who try to persuade you to buy equipment that may not meet your needs fully or is over-priced. Buying from a company that belongs to a trade association, such as the British Healthcare Trades Association, may give you some reassurance as members have signed up to a code of practice governing standards of customer service.

Charitable trusts may sometimes provide funding for equipment. There are a number of websites which can help you to search for organisations that give grants, including for equipment and other services.

Before considering high-tech equipment to prompt, warn or trigger alarms, consider simple solutions that may remove risk. Some hazards cannot be anticipated, for example the light bulb blowing when you are walking upstairs. Others are more apparent and it is therefore possible to reduce risk or get rid of the hazard completely. So, for example:

• Remove loose rugs as these are a trip hazard;
• Make sure stairs and passageways are kept clear of clutter and that the stair carpet is securely fixed and isn’t worn;
• Make sure lighting is adequate. Fit long-life light bulbs;
• Look at the layout of furniture – you may be able to create a safer space by rearranging or reducing the furniture in a room;
• Use equipment that is designed to provide support, such as grab rails and walking aids, rather than leaning on fixtures, such as door handles and towel rails;
• Place electrical items near to power points to avoid trailing flex;
• Wear good fitting and sensible footwear.

Potential solutions should be explored as early as possible, although this is not always easy if the person does not acknowledge or even realise that he or she is experiencing any difficulties. This is particularly relevant when a person has dementia. Introducing change, whether it is in the way things are done or through using equipment, can in itself pose problems for people who are set in their ways or find it hard to learn new tasks. Change has to be at the right time and at the right pace.

Familiarity with an environment contributes towards a person feeling secure and confident. However, over a period of time people often accumulate a lot of clutter that can increase risk. By simplifying and organising your belongings, the home can become a much easier place to live independently. For a start keep regularly used items close to hand and remove items that are no longer used. Keep essential things where they can be seen to act as a visual prompt – for example medication and house keys. Basic tips include:

• Having an organised approach to everyday tasks can help to solve some difficulties of forgetfulness and can reduce energy expenditure so that tasks become more manageable.
• Have a daily routine. Doing things in a regular order everyday, and having set days of the week for less frequent tasks, can help memory.
• Have a central point of reference, for example a notice board or white board, on which a weekly plan can be displayed and where you can post reminders.
• A checklist can be ticked off as a reminder of what has been done, and also gives feedback and reassurance to family and carers.
• Sometimes it helps to do things as you go along, for example keep a ‘running’ shopping list so that as you finish items they are added to the list.
• Avoid getting overtired – you will not function well both in body and mind. There may be times in the day when you can manage better, for example after medication or first thing in the morning.

It is necessary to consider any ethical implications before you choose to install some kinds of equipment, particularly equipment or technology which has the potential to limit a person’s choice, freedom or privacy. Telecare can have substantial benefits, and enhance your safety, dignity and independence. However, like any technology there is the potential for it to be misused. There will be pros and cons regarding any potential solution. 

The requirements and wishes of everyone involved, particularly the service user and the carer, need to be respected and every effort needs to be made to ensure all parties understand how the equipment and service will work. Particular concerns can include:

• The possible impact of telecare on care services and how it may be used to cut back care services and reduce the time carers spend with service users.
• That technological solutions may be installed without fully involving or obtaining the informed consent of the individual/s involved. This can be particularly relevant when the equipment is used to support individuals with conditions such as dementia.
• That particular types of telecare device, especially those used for monitoring individuals’ movements, may affect the privacy of the individual. Privacy and freedom of movement in our own homes and in public areas are human rights. Thus there are concerns about the balance between risk and protection and about telecare being used to impose conventional lifestyles on people, for example keeping regular bed times.
• That assistive technologies, including telecare, may be used to do tasks an individual is still able to do for themselves. This may contribute to them losing these skills sooner than would otherwise have been the case.
• That the use of computer technologies rely on sharing and storing information. There is a need to ensure such information remains confidential, is not misused or negligently passed into the wrong hands.
• That the devices may make daily activities more complicated or increase an individual's anxieties that they may unintentionally activate the alarm or damage the equipment.
• That the use of telecare equipment may tend to encourage a one-sided focus on an individual’s problems and not on their existing strengths.

There are no uniform 'answers', 'rights' or 'wrongs'. However, it may help to consider the following issues. You can use these points to shape your discussion with the providing company or at an equipment demonstration centre.

• Your personal motivations, perspective and preferences and your involvement in planning the introduction of equipment or changes to existing equipment. Do you understand what the telecare is supposed to do and the options available? Have you agreed that you would like to try the equipment/service?
• The nature of your disability, for example is it progressive, or do your needs fluctuate with 'good' and 'bad' days. How might technology help with this?
• Your living arrangements, family support and the needs of any carer/s. Their perspectives, personal fears, anxieties and agendas may need resolving as may those of any professionals involved.
• The reliability and safety parameters of the telecare equipment.
• Does the situation really call for an equipment or telecare solution? Is there an overreaction to an incident that has only occurred once? Are there alternatives to equipment? Ideally the focus will be on reducing risk, not the person's freedom to make decisions which may involve risks. For example, if an individual is going out and perhaps getting lost or disorientated then one approach may be a telecare door sensor, another approach may be to provide someone to walk with them. If they are going out because they are looking for social contact then this will not be resolved by technological solutions.
• How will the usefulness of the telecare equipment and service be reviewed and evaluated? If you change your mind about having the equipment what will happen?

Some people have difficulty remembering the day of the week and the time of day, i.e. seven in the morning or seven in the evening, especially in the summer months when there are more daylight hours. Also, confusion can arise in the winter months when the evenings draw in early – it can be dark at 5pm, but it is not bedtime.

Possible solutions include:

• A daily timetable written out by a carer or relative can help by giving structure to the day. It could include, for example, visiting times for carers, meal times, and the time and channel for favourite TV programmes. It could be written on a white board, wiped off and replaced each day.
• A wall clock with clear, bold numbers may help with time orientation. Some also show the day of the week and/or date. Some have a symbol for night or day. Some can simply show the name and relevant part of the of the day.
• Important dates, such as birthdays and doctors appointments, written down at a central point of reference such as a white board.
• A calendar with bold script and a clear space for writing. Days can be ticked off before bedtime.

Prompting devices are available that play a short pre-recorded message when they sense movement. For example, you could place one near your front door, so that when you approached the door it would automatically remind you: 'Put your safety chain on before you open your door to a caller' or 'Don't forget to take your keys when you go out'. Thus these devices can provide a useful prompt if you are experiencing difficulty with your memory. However, the maximum message length is quite short; 10-20 seconds on most models.

Devices are also available that automatically display or play messages at preset times. For example, they could remind you at 11.00 every Thursday that you are due to be picked up at 11.30 to go out for lunch.

There are pendants available to wear which play an alarm at a preset time. They then require the wearer to push a button in order to hear a pre-recorded prompt or instruction.

There are a number of applications for smart phones and tablets, some of which are free, which can be used to remind the user to carry out certain activities, such as taking medication. This might be useful for someone who is already familiar with using a phone/tablet.

It is essential to get medication doses and times right because getting them wrong can affect health and wellbeing. Problems include:

• managing childproof containers;
• reading the labelling;
• remembering what medication to take;
• remembering when it should be taken;
• remembering whether it has been taken;
• taking a repeat dose/s.

Keeping medication where it can be seen easily can in itself act as a prompt to taking it.

Tablets can be transferred into a pill or dosette box, a compartmentalised box marked with dosage times. Boxes have a flip lid or a sliding lid that should be easier to open than a pill bottle. The empty compartment provides a reminder that the dose has been taken.

The boxes come in a range of complexity. Some just provide for a single day’s medication, others take a full week’s supply of tablets with days of the week clearly labelled. Some allow for multiple doses each day throughout a week.

The user or a family member will need to be able to transfer the medicines into the dosette box when needed, ensuring that the right medicines are inserted for the right times. If a person finds it difficult to load the pill box, some pharmacists can dispense prescribed medicines into dosette boxes or blister packs (or dosage cups for liquid medication). They may charge for this service. Some require your GP to request this service. Blister packs can be difficult to open for those who find fine movement or grip difficult.

Some medication needs to be kept airtight. Check with your pharmacist whether your medication could be stored in pill boxes or other dispensers.

Dispensing pill boxes use a mechanism that will physically move the pill compartments so that you are offered the correct pills at the correct time. These units use rotating carousels that require loading with a week or a month's worth of pills. Different models are available, with larger models allowing a greater number of pills or larger tablets to be dispensed. You will need to consider who is going to load these carousels before purchase. If the dispenser is to be filled by a chemist then you may need to purchase extra carousels so you can have one in use and one at the chemists.

Pill boxes are available with flashing lights, alarms or vibration to prompt you to take your medication at preset times. Some people may find setting up these devices complex and fiddly so help from a family member or carer may be needed.

Alternatively you could wear a watch, or use a clock, that allows you to set multiple daily alarms to remind you when your medication is due. You may wish to use this in combination with a dosette box to help organise your pills.

Telecare pill dispensers may also be available as part of a telecare package, they will automatically notify a monitoring centre if the medication is not tipped into the saucer so that it is ready to be taken. Some models can text or email a friend or relative if the medication is not taken.

If you use a smartphone or tablet and are confident using apps you could try a medication reminder app. These can be downloaded to compatible smartphones and are designed to give a reminder when your medication is due. You, or someone you know, has to set the dosage times and names of the medication before the reminders will work. Some give an audible reminder, others just a visual reminder when you check the screen.

Smoke detectors should be fitted in all households and some local fire brigades may fit them free of charge for older people. Ideally, smoke alarms should be mains powered so that their effectiveness does not depend on battery life. For people with a hearing impairment who may have difficulty hearing an alarm, smoke alarms are available that flash a strobe or light. At night some systems can trigger a vibrating alarm designed to be placed underneath a pillow.

These will automatically sound an alarm in your home and send an alarm call to your monitoring centre if it detects smoke. The monitoring centre can then alert the fire brigade. These alarms may be appropriate if you would find it difficult to get out of your home promptly, or might not remember what the smoke alarm was for.

If a telecare smoke alarm is not installed as part of your telecare system, you should still have at least one working standard smoke alarm in your home which will sound an alarm if it detects smoke but these will not automatically alert your help centre.

Smoke alarms are not generally recommended for kitchens as some smoke can be expected from cooking and toasting. Consequently a temperature extremes alarm or heat alarm may be considered. They work by detecting extremely high temperatures and also monitoring the rate of any rise in temperature. As with smoke alarms, standard models are available from high street retailers and telecare compatible temperature extreme alarms may be available as part of a telecare package.

Carbon monoxide alarms will sound an alarm if they detect carbon monoxide. Carbon monoxide is a gas which has no smell, taste or colour. It is produced by the incomplete combustion of fuels including gas, oil, coal and wood used in boilers, gas fires, water heaters, solid fuel appliances and open fires. Exposure to above-recommended concentrations of carbon monoxide can cause headaches, dizziness, nausea, convulsions and death. Gas appliances that are old or have not been regularly serviced can present an increased risk of carbon monoxide poisoning. A servicing contract would ensure that appliances are checked annually and are in good working order. Servicing companies generally take on the responsibility of contacting their clients when a service is due, making it one less thing to remember.

As with smoke and heat alarms, carbon monoxide alarms are readily available on the high street. The ones we list have non-standard features such as integration with strobe or vibration systems for individuals who are deaf or have hearing loss.

A telecare enabled carbon monoxide alarm may be recommended if you may not remember what a standard carbon monoxide alarm is for, or what action to take if it goes off.

Many individuals prefer to use gas ovens, and especially gas hobs to electric hobs. However, problems include:

• turning on the gas and forgetting to ignite it;
• leaving pans on that boil over, extinguishing the flame;
• forgetting that foods have been put on to cook;
• old appliances that may be a safety risk.

Leaking gas is dangerous. Ultimately, leaking gas can build up to dangerous levels which can result in explosions. Many newer cookers will automatically cut the gas off if the flames are not ignited, but older models may not have this safety feature. One option to manage the danger of un-ignited gas is to fit a natural gas alarm (not to be confused with carbon monoxide alarms) that will sound when the sensor detects gas. Some only sound an alarm, so someone must recognise what the alarm is for and act on it. Others actually turn off the gas supply.

Gas alarms can also be linked to telecare alarm systems. These may be appropriate for individuals who live on their own and may not remember what the gas alarm is for if it goes off. 

If you smell gas ring the gas emergency number: 0800 111 999

In situations where you want to manage when a person uses the gas cooker so they don’t use it when he or she is alone in the house, a gas isolator switch, fitted by a gas safety registered engineer, can be used to turn off the gas supply to the cooker.

Microwave ovens have some useful safety features: only small amounts of water are needed for cooking; they cook for a pre-selected period of time; and containers designed for use in the microwave should not get as hot as those in an oven. The drawback is that learning to use a microwave might be difficult, for example remembering not to use metal or foil containers. Talking microwaves are available, designed to assist users who cannot see the displays by speaking the settings out aloud.

Induction hobs may be worth considering as they often have a timer built in and they only heat the pan, which means you can touch the adjacent surface without burning yourself. Rather than the cooking surface heating up, a magnetic field is created between the pan base and an element underneath the glass top. However, the saucepans you use need to be induction compatible and induction hobs may not be suitable if you have a pacemaker fitted because of the powerful electromagnetic field.

Devices are available to automatically turn off an electric cooker after a certain time, or if a sensor detects too great a build-up of heat.

A timer can be used to remind a person of the required cooking time. Some are mechanical, some digital. A few are a combination of the two. A mechanical timer, which might be more familiar and easier for older people to use, stops when the spring has wound down. An electronic timer might be more difficult to set but may sound for longer, or stop and then sound again after a short interval. Some also provide a visual cue of the time left.

Keep the timer next to the cooker to act as a prompt to set it. There is also a device that goes into the bottom of a pan and rattles when the liquid boils to provide an alert. The timers we list have features such as large digits or a talking read out of the remaining time for individuals who cannot see the display.

Electric plug-in adaptors are available from high street stores that will automatically turn off plugged in appliances after a preset period of time (e.g. 5 or 30 minutes). They are usually marketed at an energy saving device, but may be a good safety precaution, especially for appliances that heat up like irons.

The bathroom can be hazardous so it is wise to bathe when there is someone else in the house if this is at all possible. Water spills increase the risk of slipping, and a hot, steamy environment can cause giddiness. Should a fall occur behind the door, it will obstruct the door and prevent a helper from gaining access.

Consider the following safety tips:

• reverse the swing of the door so that it opens outwards;
• do not lock the door, or alternatively fit a lock that can be opened from the outside in an emergency;
• take with you a means of calling for help, for example a cordless phone handset or a pendant alarm.

Healthy adult skin requires only 30 seconds of exposure to water at 55 degrees centigrade before third-degree burning occurs. At 70 degrees centigrade, burning occurs in less than a second. Thermostatic valves can limit the temperature of hot water coming from a hot tap or shower. Water temperature indicators can show when the temperature of the bath or wash hand basin is above a safe level by changing colour or giving a reading of the water temperature. They are preset within a safe range which is usually 34-37 degrees centigrade for the bath and usually 42-47 degrees centigrade for the wash basin. When the temperature of the water goes higher than this they may change colour or sound an alarm.

Night-time disorientation can be difficult. A plug-in night-light can provide a low lighting level without being too bright and disturbing sleep. Many have a light sensor so it will turn off automatically during daylight hours, but come on again at dusk. If the person needs to get up to use the bathroom at night there’s often a reluctance to turn on the main lighting as it can be dazzling, so once again, night-lights can help.

There can be a degree of urgency that requires the person to get to the bathroom within a reasonable time. The route through to the bathroom and back to the bedroom can be defined using progressive lighting – as the person moves from one area to the next, the lights ahead illuminate whilst those behind dim. This helps to:

• steer the person to where he or she needs to go;
• steer him or her away from hazards, e.g. the stair head;
• reduce the risk of the person disturbing other household members;
• reduce the need to call for help from a carer.

Sensors are available that sound an alarm or text a number if the temperature falls below a certain level. This may be referred to as a hypothermia alarm. This may be considered, for example, if you have a history of turning your heating off and forgetting to turn it on again during cold spells. Telecare temperature extremes alarms can also be used to alert a monitoring centre if the room temperature falls below a preset level. If low temperature triggers the alarm then the help centre may contact you and/or your friends or relatives to prompt you to check your heating.

There are many reasons why you may feel the need to move and walk about more than usual. These may include a response to anxiety, to relieve pain or discomfort or becoming confused about where you are. This may result in you walking from an area of relatively low risk to an area of high risk, possibly getting lost or disorientated, especially at night. There may be safety risks associated with going into certain areas of your home alone, particularly if you experience difficulty when walking such as limited balance, for example out of the bedroom onto the landing where there is a risk of falling down the stairs.

You can use automatic, pre-recorded prompts to either provide reassurance that it is not necessary to get up, to warn against entering a particular area, or against leaving the home. Prompting devices (see above) are available that can be triggered by movement in front of them. You could, for example, mount one above a chair or next to a doorway.

Alternatively you may wish to use movement alarms, described below, that will alert someone in your home, such as a carer or relative, that you have got up from a bed or chair, or are in a specific area. They can then come and provide assistance. These alarms often consist of a pager that a carer/relative can take with them into another area of your home or garden.

This range of equipment is designed to raise an alert if an individual leaves or enters a specific room or area of the home. Perhaps this would be because the individual needs supervision on the stairs or in the kitchen.

The sensor may consist of a pressure mat for use on the floor or a sensor beam/detector. Pressure mats can become a trip hazard if inappropriately positioned. The sensors may use passive infrared movement detectors which detect body heat or use two sensors with a beam between them. If the beam is broken by someone walking past, then the alarm sounds.

Some sensors sound an alarm, or tone, on the sensor itself, others can trigger a pager that can be 100-300 metres away.

These sensors have pads which are placed under your mattress or chair cushion and can detect when you’ve left your bed or chair. They can either trigger an alarm immediately or start a timer. If you don’t get back into your bed, or chair, within a preset time then the alarm sounds. This means that if you go to the toilet, or to the kitchen for a quick snack, and return to bed, your alarm will not be activated but if you fall and do not get back into bed the alarm will be raised. The pads usually trigger a pager that can be 100-300 metres away, although some simpler units sound an alert on the sensor unit itself.

These sensors trigger an alarm, or tone, when a door is opened. For example, this may be considered if you regularly become disoriented to the time of day and leave the house at night thinking it’s daytime. The sensor usually triggers a pager that can be 100-300 metres away (although some simpler units sound an alert on the sensor unit itself). Thus a carer or relative could keep the pager by their bed and, if it goes off, come and assist you.

Some sensors attach to the door and door frame, often requiring a couple of screws. Alternatively some sensors are fitted beside the door frame and the user wears a wrist worn device. The alarm only sounds if the individual/s with the wrist worn device goes through the door.

As with smoke, gas and carbon monoxide alarms, door exit detectors may, in some cases, be integrated with a telecare alarm system.

Personal locators are portable products designed to be carried by you when you go out. They enable authorised individuals, such as relatives or carers, to find out your location by logging onto the internet from a computer or smartphone. Most work via GPS (a satellite based global positioning system) and will allow individuals you have authorised to find your location (if you are carrying the device) to approximately 10 metres. They may not be able to find you if you are indoors unless they also contain GSM mobile phone technology.

Several personal locators offer the option of Geo-Fences. This is the possibility of entering a predefined area into the unit. If you leave this area with the unit then an alarm/alert is raised. Depending on the model this may involve designated contacts such as a friend or relative being informed by a text message. These devices will require an ongoing subscription for the service.

You could use a mobile telecare alarm which allows you to contact/alert a monitoring centre at the touch of a button. They can then find your location using satellite or mobile phone technology and contact someone you have nominated or the emergency services. These devices will also require an ongoing subscription for the service.

People who require support to live independently may well have to give access to their home to a range of different people involved in their care, while still feeling safe within their home. For example daily carers visiting to help with personal care and meal preparation or emergency responders to a telecare alarm activation. Problems may include:

• the number of duplicate keys to be cut;
• losing keys;
• controlling access to the home;
• worrying about a potential increased risk from intruders;
• keeping the house secure.

A key safe is a secure metal box that stores a key, and is designed to be mounted outside by the front door. The safe is opened by a numeric code that must be punched in. A single copy of your key/s are placed inside but can only be retrieved by someone who knows the correct code to open the box. It is up to you who you give the code to and you can change the code as often as you like. Choosing a code made up of familiar numbers, such as a birth date can help someone with memory difficulties to remember it. A key safe provides a useful way of giving access to the home to regular callers, such as carers and relatives, and also provides a ‘spare’ should the homeowner leave the house without the key.

If your keysafe is provided by your local council, they will often arrange for its fitting. If you buy your own and you do not know someone who could fit it for you, you may find that your local AgeUK have a handyman service which can help for a small fee.

Keysafe units are usually wall-mounted (into brick or concrete), although there are some that have a locking shackle (like a padlock) or that slip over the top of the door and are kept in place by closing the door. Key safes should be installed out of easy line of sight. Tests have shown that some key safes are more secure than others which may determine whether they are approved by home insurance providers.  One relevant standard that some key safes meet is LPS (Loss Prevention Standard), a specification for testing and classifying the burglary resistance of building components, strong points and security enclosures. There is a wealth of information online about keysafes and their installation.

Losing keys is a common problem, but having a set place to keep them may provide a solution. There are also electronic tags that can be attached to keys to help someone to find them when they have been mislaid within the home. The electronic tag is activated by pressing a button on a transmitter remote control, and will bleep.

Opening the door to strangers can be risky. A door viewer, a chain or intercom (see below) can provide a way of identifying the caller before the door is opened fully. Memory prompt sensor devices that give a recorded warning could be triggered as you approach the door from inside. For example, it could automatically remind you: 'Put your safety chain on before you open your door to a caller'.

If you have a telecare system installed then telecare buttons may sometimes be placed near the front door. These may be called ‘Bogus caller buttons’ or 'panic buttons'. This allows you to simply press the button, automatically raising an alarm at your help centre, if you fear that a bogus caller is trying to trick you or break in to your property. The alarm call can be programmed to be silent so that the bogus caller is not aware they are being overheard by your call centre. The call centre can listen to the situation and intervene, perhaps calling the police, if necessary.

A door entry intercom is a remote way of checking who is at the door before giving access. Intercom systems also enable sound or speech to be transmitted between two or more locations in the same house.

Systems may be mains or battery operated and either connected by a wire or wireless. Some only allow one-way communication, others are two-way, allowing full conversation. Some have a handset which must be used when speaking through the system, others have a hands-free facility. This may allow the unit to transmit messages once speech is sensed. If no speech is sensed, the unit remains on receive mode.

Video intercoms are available which display a TV image of the speaker, as are intercoms that also control a remote door release. These may be useful if you find it difficult to get to your front door to let callers in. You can check who it is using the intercom or video and decide whether to let them in using your handset.

One-way intercoms (as in a baby alarm) enable sound to be transmitted in one direction. For example, they enable you to hear when your child, or the person you care for, is crying or calling for help. Some of these monitors incorporate a vibrating pad or pager and/or a flashing light for parents/carers who are deaf or hard of hearing. The vibrating pads can be placed under the carer’s pillow at night time. Some also have a visual sound level indicator - e.g. rows of light that increase as the sound made increases. If you are a carer who is deaf or hard of hearing, you may like to get in touch with Action on Hearing Loss. The contact detail are below.

Two-way intercoms have two-way communication allowing for room-to-room conversation. Intercoms can be used to monitor someone’s activity. All methods of monitoring, whether by checking on someone physically, or by using technology, should be considered in relation to the possibility of intruding into a person’s privacy.

Since the telephone is a vital communication tool providing reassurance through social contact and a way of calling for help, it is important to ensure that it is always accessible. Common problems include:

• reaching the telephone in time to answer it;
• managing small buttons;
• remembering numbers.

Have your telephone in the room in which you spend most of the time – this is likely to be the living room, and near a chair so that you can sit to use it. It is a good idea to have an extension in your bedroom, close to the bed, and anywhere else where you spend significant amounts of time. Several big button telephones on the market provide ease of dialling. Most can be programmed to store frequently used numbers, retrieved by one or two key presses. Some models allow photographs or names to be stored on the memory keys which can prompt the user to the location of the various numbers. Telephones with a digital display can help the user to check the number for accuracy after it has been keyed in and before it is dialled. Alternatively, some models will read out numbers as they are dialled so you can check what number was pressed.

Telephones are available with an amplified ringer, visual flashing ringer and/or amplified speech which may help if you have hearing loss. Many phones are compatible with hearing aids.

Cordless telephones can be carried with you around the home and garden, but must be replaced on the stand regularly to recharge the batteries. If the handset is misplaced, the stand usually has a paging button that will cause the handset to bleep to help you to find it.

Mobile phones provide an extremely portable way of making telephone contact when you are out and about. However, many are small and complex, so may not be suitable for people with limited dexterity, vision or memory. Remembering to charge the telephone can be an issue. There are now several mobile phones designed specifically for easier use. They have varied features depending on the model but may include larger keys, direct dial memory buttons, a docking station for charging and clear high contrast screen.

The anxiety caused by not being able to get help if something goes wrong, can limit activity and have an impact on independence. An intercom, pendant and pager or alarm provides a way of calling for help.

Short range pendant alarm buttons that signal to a portable pager receiver can give a carer more freedom to move around the home and garden. If the button on the pendant is pressed, the receiver may sound an alarm or vibrate to alert the carer. These are designed so that the user of the button can signal to the person with the receiver that they would like assistance. Some systems have a fixed transmitter, like the nurse call buttons by hospital beds that are fixed to the wall. Some have a non portable receiver such as a box that plugs into the mains with an alarm and/or flashing light. However the majority of systems now have a portable transmitter and a portable receiver like a pager that beeps and/or vibrates when the pendant alarm button is pressed.

The maximum range between the pendant and the pager varies between models and will depend on how your home is constructed (for example, how solid and thick the walls are) but most systems have a range of between 100 and 400 metres. The pendant can usually be worn around the neck or on the wrist. The pager signal is usually a buzzer, vibration or tune.

Check that you are able to operate the alarm button easily, that the signal reaches as far as the likely locations of the receiver (for example, the garden or an upstairs room) and that your carer can hear the alarm signal.

Autodialler alarms ring a preset series of numbers to friends or relatives when you press a button on a pendant. Most autodialler alarms have a portable pendant transmitter that is worn around the user's neck, or wrist. When the pendant button is pressed it sends a radio signal to a table top alarm unit placed near your phone socket. The unit will automatically dial several numbers in turn (which you have preset), until it receives a response. These numbers could be for relatives or friends and a combination of mobiles and landlines. Programming to dial more than one number increases the chances of the call being answered. You should not programme the unit to call the police, a doctor or anyone else without their prior permission.

There are significant limitations of autodialler alarms compared to telecare systems that connect to a 24-hour monitoring centre and can guarantee a response 24 hours a day, every day. The individual relatives and friends whom the autodialler rings are unlikely to be able to answer their phone 24 hours a day, they may not always have mobile phone reception, and they may not be available to act immediately. Autodialler systems also tend to have fewer automatic checks to alert you, or someone else, if something goes wrong. For example, they may not warn anyone if they are disconnected from the phone line, the mains electric, or if the battery in the pendant starts getting flat. These are standard safety features in telecare systems.

However if the system does get through to one of your contacts you know they will be a familiar person who knows your situation. You do not need to pay an ongoing weekly or monthly charge for the service (you do need to pay your standard line rental charges to keep your telephone line). Thus they may suit your needs if you live alone, or spend time alone, and would like to be able to get in touch with friends/relatives who live locally with one push of a button, but don’t anticipate emergencies where an immediate response is critical.

Mobile phones with an emergency or ‘panic’ button that works in the same way are also available. Pressing the button will call or text a series of preset numbers until it receives a response. Some of these mobiles can automatically include your location in the text messages they send when you press the emergency button. These systems have the advantage that they may work outside of the home but they have the additional limitations that they will not work if the mobile does not have reception, or has a flat battery. They also require an ongoing contract, or regular topping up of pay-as-you-go credit.

Emergency identification devices include pendants and bracelets which carry vital details of your identity, medical condition and contact telephone numbers. They are designed to be worn whenever you go out, or carried in a purse or wallet. The details they carry may be very useful if you have an accident or become confused or disorientated and require assistance.

The Message in a Bottle scheme is a simple initiative to encourage people to keep their personal and medical details on a standard form and in a common location - the fridge. This can save the emergency services valuable time in an emergency. The ‘bottles’ are easily recognizable plastic containers. They are free of charge, and can usually be found in local chemists or doctors’ surgeries. You may also find that you can obtain one through Neighbourhood Watch schemes, from Age UK, local authorities, housing associations or police stations.

3 Fun and Free Medication Calendar Printable Sheets

This post may contain affiliate links, for more information see DISCLOSURES

A printable medication calendar! My holiday gift to you!

A I’ve been hearing about the popularity of printables for some time. So, I decided to use Canva and finally give making some a shot.

A Fun and Easy Printable Medication Calendar

I often thought if my son had been a bit older when he was taking his cancer medications, that we might develop a fun tracking system to help keep him engaged.

Given that he was only a toddler in the midst of his cancer treatment , medication compliance tools weren’t really fun or a motivator for him.

But the thought was in my mind.

Though making taking medications more fun and easy for kids was the reason that I created these calendars, there is totally no reason that these can’t be used by adults too.

3 Free and Fun Daily Med Trackers

I designed these daily medication calendar trackers for adults and kids. For the kids (or anyone) we have a happy little pill. And for those who want to keep things a bit more serious, a heart rhythm. I even decided to make one for our furry friends as a veterinary pet medication calendar printable too, Remembering pet meds can be harder than remembering our own!

How to Use a Medication Calendar Tracker

I set these up to be easy and customizable for you to use. The pill that was selected has two halves, to it is quite easy to designate one side for “AM” and one side for “PM” and color in which have been taken.

Or, you (or the child) can color in the whole tablet if it’s only one per day. Or, if if the medication is administered 3 times a day, draw a line down one half and now there are 3 parts to color in. Lots of options!

Starting New Medications Using the Medication Calendar

These are especially helpful for someone who is starting a new medication or doesn’t take them very often. You can even use them to keep track of your pet’s medication calendar!

Sometimes when starting a new prescription, you might only take half a dose for the first week or two. This calendar can be used to visually remind yourself of what you’re doing and where you are in your medication tapering process.

Tapering Off of Medications using the Medication Calendar

Stopping a medication once you have started can be just as hard as getting into the initial habit. If you have a specific schedule you can note it and track it visually with this printable.

Helping Elders Remain Independent Using a Medication Calendar

It may sound silly that giving grandma a coloring sheet could help maintain her independence, but it’s true.

Medical folks often develop aids like this (though, perhaps not quite so fun and pretty) to help patients remember to take their meds.

If you know an older person who takes a few meds and might be struggling to remember, this might be something that can help. Print out 4 daily daily medication calendar tracking sheets (or however many are needed for their medications), develop a color coding system for different pills and set it up on the fridge or a clip board. Pill boxes are great, but sometimes a bigger, more fun looking visual reminder that is accompanied by an activity can help to get people back on track with taking their medications. The medication calendar can also serve as a visual reminder to the individual and those assisting in their care of days or times where they might be struggling with their medication adherence. Seriously, it might seem a little silly, but give it a try!

Happy Pill Medication Calendar Tracker by That Frugal Pharmacist

Heart rhythm medication calendar tracker by that frugal pharmacist, pet med medication daily tracker by that frugal pharmacist, please share your medication calendar success stories.

This is my first go at making a printable, which is part of why I am sharing this for free today. If you really like it and feel like donating some to my efforts, here is my KoFi.com link where you can donate as much or as little as you’d like!

I would love to hear your feedback. What works? What could use improvement? Success stories and so on!

There is no health like wealth, and helping you and yours stay healthy and wealthy is my holiday wish to you!

That Frugal Pharmacist

Regina is That Frugal Pharmacist. She’s a PharmD, mother to a son with cancer, breadwinning wife, personal finance enthusiast, artist, writer, and entrepreneur. Regina’s single-income household has been debt-free, including her home, since she was 28 years old. Her money approach is “holistic financial health.” She encourages mindful spending, awareness of the non-monetary costs of choices, and aligning personal values with money habits. Regina sees a frugal lifestyle and mindset as an important part of environmental stewardship. As such she’s interested in ongoing efforts towards self-sufficiency and sustainability.

• That Frugal Pharmacist https://thatfrugalpharmacist.com/author/that-frugal-pharmacist/ To Open a 529 College Savings Plan or Not?
• That Frugal Pharmacist https://thatfrugalpharmacist.com/author/that-frugal-pharmacist/ How do you build a life you don't feel like escaping?
• That Frugal Pharmacist https://thatfrugalpharmacist.com/author/that-frugal-pharmacist/ Frugal Travel in India - 3 Unique Tips!
• That Frugal Pharmacist https://thatfrugalpharmacist.com/author/that-frugal-pharmacist/ Frugal Health at the Pharmacy: MTM? CMR?

Share this post:

1 thought on “3 fun and free medication calendar printable sheets”.

Pingback: How to Find Cheap Vets Near Me - Wallet Squirrel

Leave a Comment Cancel Reply

Your email address will not be published. Required fields are marked *

• Store Your eScripts
• Skip the Queue
• Dosage Reminders
• NDSS Supplies
• Prescription Delivery
• Book Your Flu Vaccine
• Book Your Covid-19 Vaccine
• Project STOP
• PlusOne Pharmacy Software
• Pharmacy Webinars
• Pharmacy Shop
• Behavior Change Programs
• Medicines Information
• medsinfo.com.au
• Testimonials

Never Miss a Dose Again: Powerful Medication Reminder App at Your Fingertips

Connected to over 95% of australian pharmacies.

Say goodbye to forgetting your medication with our intuitive medication management app.

Manage your medication and stay connected to your pharmacy with our free app.

Why You Need a Medication Reminder App

Explore the features loved and relied on by more than 3 million Australians.

Improved Medication Adherence

Reminder alerts improve medication adherence, reducing missed or incorrect doses and enhancing overall health outcomes.

Avoidance of Medication Errors

Timely reminders minimize medication errors, preventing double doses, skipped doses, and wrong timing.

Enhanced Convenience

Get reminders on your smartphone or other devices to take your medications, even when you're busy or on the go.

Peace of Mind

Dosage reminders bring peace of mind by ensuring accurate adherence to prescribed treatment plans, alleviating anxiety and stress from managing multiple medications or complex dosing schedules.

Streamlined Prescription Management

Get dosage reminders and order repeat prescriptions with MedAdvisor to easily manage your medication.

Set reminders for loved ones to never miss medication doses, promoting adherence and overall well-being for both caregivers and those under their care.

How to make the most of your dosage reminders?

Set medication reminders easily by adding a new alarm in the 'Daily alarms' section of the MedAdvisor app.

Name the alert, schedule a time, and link it to your medication.

The reminder will come as a push notification at the set time.

If you have any further questions, please contact us on Support. We're always happy to help. Our support team is available Monday to Friday, 9AM–5PM (AEST).

Having the MedAdvisor app on my phone has just taken away any angst and concern that I had beforehand. It does all the thinking for me.”  Brooke, Stroke Survivor and MedAdvisor User

Trusted by over 3 million people worldwide

Facebook Fans

Apple Store Reviews

Google Play Reviews

"This app is a must-have for those that take regular medication. The tap-to-order function is a godsend!! And the reminders are great when a dosage has changed. 5 stars." - Ruth S, Android App User

"No need to ever wait in queues to order meds. I love this system as I can place an order in the morning and it is ready to pick up on the same day." - David Crennan, Android App User

"Simply no words can describe the ease of use and functionality of this application. Thank you for producing such a program that is light years ahead of any other! 5 stars from me!!!" - Emily Hum, Android App User

"It just make keeping track and ordering your meds so so much easier. There's no need to sort through all your paper prescriptions & repeats anymore!" - Gillian_troubat, Apple App User

"This app has helps me to manage my medications. I was forever forgetting to take medicines and running out and getting stuck. This never happens any more. I'm very grateful. Thank you" - Saskatoon James, Apple App User

See for Yourself

Download The App Today

Medication Management FAQs

A medication management app is a mobile application designed to help individuals manage their medications and improve medication adherence. These apps often include features such as medication reminders, refill alerts, and dosage tracking, as well as the ability to store information about medications, such as dosage, frequency, and side effects.

MedAdvisor is a medication management app that offers these features and more, allowing users to keep track of their medications and receive reminders and alerts to ensure that they take their medications as prescribed. The app also offers a range of other services, including medication delivery, prescription ordering, and medication review services. By using MedAdvisor, individuals can better manage their medications, improve medication adherence, and stay on top of their health.

No, a medication management app cannot replace a doctor's advice or prescription. While medication management apps can be helpful tools to assist with managing medications and improving adherence, they are not a substitute for medical advice from a healthcare professional. A doctor's advice and prescription take into account a person's individual medical history, current health status, and any other medications they may be taking. This personalized approach is important in ensuring that medications are safe and effective for the individual.

Additionally, medication management apps do not have the ability to diagnose medical conditions or adjust medication regimens in the same way that a healthcare professional can. It is always important to consult with a doctor before making any changes to medication regimens or making decisions regarding healthcare. Medication management apps like MedAdvisor can be a helpful tool to supplement medical care, but they should never be used as a replacement for professional medical advice and treatment.

Medication management apps, like any mobile application that handles personal health information, should prioritize the safety and security of their users' data. Reputable medication management apps, such as MedAdvisor, take extensive measures to ensure the safety and security of user data. These measures can include using data encryption to protect sensitive information and complying with relevant data protection laws. It's important to note that users also have a role in ensuring the security of their data when using medication management apps. This includes taking precautions such as using strong passwords, keeping their app up-to-date, and being aware of the app's privacy settings and permissions. Overall, when used responsibly and with proper precautions, medication management apps can be a safe and secure way to manage medications and improve adherence.

For more information visit - https://www.mymedadvisor.com/data-and-privacy

The cost of using a medication management app can vary depending on the app and the services it offers. Some medication management apps are free to use, while others may require a one-time purchase or a subscription fee to access all of their features. For example, MedAdvisor is completely free to download and use. The app provides medication reminders, refill alerts, and basic medication information for free to its users. There are no hidden costs or subscription fees to access these features.

Users only have to pay for the medications they are ordering through the app, and the payment is made directly to the pharmacy. MedAdvisor partners with a variety of pharmacies to offer convenient medication delivery and prescription ordering services to its users. Overall, MedAdvisor is a free and accessible tool that can help individuals better manage their medications and improve adherence.

MedAdvisor International Pty Ltd

Level 2, 971 Burke Road Camberwell VIC 3124 Australia

Email us: [email protected]  

MedAdvisor is an affiliate member of the World Pharmacy Council.  

• Flu Vaccine
• Covid-19 Vaccine
• Pharma Patient Experience Platform

Useful Links

• Pharmacy Covid-19 Resources

SPS - Specialist Pharmacy Service

• Guidance index
• Administering
• Cautions and contraindications
• Deprescribing
• Interactions
• Medication Safety
• Safety in breastfeeding
• Safety in pregnancy
• Temperature management
• Swallowing difficulties
• Stability of cytotoxics
• Aseptic services
• Intrathecal administration
• Manufacturing and preparation
• Unlicensed medicines
• Clinical Trials
• Medical gases
• Record keeping
• Search Guidance
• Care of the elderly
• Community Health Services
• Critical care
• Emergency medicine and urgent care
• Health and Justice
• Occupational Health
• Paediatrics
• Palliative and End of Life Care
• Primary Care
• Transfer of care
• Allergy and immunology
• Anaesthesia and pain
• Cardiovascular system disorders
• Endocrine system disorders
• Eyes and vision
• Gastrointestinal disorders
• Haematological disorders
• Infection and infectious diseases
• Mental health and illness
• Neurological disorders
• Nutritional and metabolic disorders
• Obstetrics and gynaecology
• Public Health
• Renal and urologic disorders
• Reproductive health
• Respiratory disorders
• Sexual health
• Skin disorders
• Vaccinating
• Wounds and injuries
• Events index
• Next events
• Past Events
• Search Events
• Advanced therapy medicinal products
• Adverse effects
• Clean rooms
• Patient Group Directions
• Safety in Pregnancy
• Planning index
• Biosimilars
• Annual medicines planning
• Search Medicines planning
• Musculo-skeletal disorders
• Training index
• All Training and Development
• Breastfeeding
• Cardiovascular disease
• Complementary medicines
• Kidney disorders
• Polypharmacy
• Medication safety
• Search Training and Development
• Publications index
• Newsletters
• Bulletins and summaries
• Research and audits
• Search Publications
• Medicines Tools index
• Medicines Supply
• MCA Stability
• Fridge stability tool
• Reminding to take medicines: supporting adherence

Interventions and tools to help improve medication adherence, where memory issues (capability) have been identified as a factor

This article forms part of a series

• Defining and understanding medication adherence
• Explaining how to use or take medicines: supporting adherence
• Complex medication regimens: supporting adherence
• Swallowing difficulties: supporting adherence
• Manual dexterity: supporting adherence
• Visual impairment: supporting adherence

Managing forgetfulness

Simplifying medication regimens, reminder systems, telephone or text reminders, medication reminder charts, computer-generated charts, alarm devices, talking watches, audible/vibrating alarm watches, programmable voice reminder, automatic medication dispensers, pill bottle top with indicator and alarms, smart phone medication reminders.

Individuals can have varying levels of difficulty remembering to take their medicine(s). This could be for a range of reasons from dementia and mental health issues to no specific reason at all.

It is important to consider what patients are currently doing to help them remember to take their medicines before providing alternative advice.

There is evidence that reducing the number or frequency of medicines where possible can improve adherence. Healthcare professionals may find our selection of tools and resources helpful when undertaking medication review.

Encourage patients to take the lead in describing their daily routine and in considering how they can fit in medication taking easily.

Reminder systems that can help include:

• positioning medication in visible places (e.g. morning medicines near toothbrush or kettle)
• associating medicine taking with meals or other regular daily activity
• fridge stickers or magnets

Telephone reminders from family, friends, carers or organised through telecare companies could help people remember to take medicines. There must be a robust system in place to inform those reminding the patient about changes to medicines.

Evidence suggests text messages or telephone reminders are most effective when they are personal or interactive whilst electronic drug monitors are unlikely to improve adherence without additional support from professionals.

Medication reminder charts summarise a patient’s medicines, what they are for, and how to take them. Some areas have their own medication chart templates.

A variety of templates can be downloaded and customised:

• The British Heart Foundation has produced a personal record for patients with heart failure which includes a chart to record medications
• Asthma+Lung UK has an easy read medicines card (A5) prompt for inhaler use. An asthma action plan and other resources are also available

Computer generated reminder charts are practical and cost effective and some pharmacies offer them free-of-charge. They can generally be produced using pharmacy dispensing systems and system providers can demonstrate how to use this functionality.

Numerous alarm devices are available. It is important patients are assessed for suitability for having these since some patients may get panicked by sudden noises or vibrations. A small selection of different devices is presented here:

A variety of alarms are available from the Talking Watch Shop . These devices allow a number of alarms to be pre-set and are suitable for the blind or visually impaired.

A variety of vibrating watches are available from Malem Medical Ltd , Pivotell and TabTime . These devices allow a number of daily audible and vibrating alarms to be programmed. They may benefit the hearing impaired.

Voice reminders can be a useful aid for those with cognitive difficulties who can carry on living independently provided that they are prompted to perform regular and occasional tasks by a familiar voice.

The Mem-X Voice Reminder can store up to 90 ten second messages. An alarm is triggered at the pre-set times to nudge the patient to play the pre-recorded message.

These devices are programmable to open sections at certain times of the day and can be accompanied by an alarm. They may be suitable for patients with stable yet somewhat complex medication regimens.  There is some evidence to support their use. However, it is important that patients are assessed for suitability for having these devices as some can be complex to use and fill.

A range of battery operated, programmable medication dispensers with audio, visual or vibrational alarms are available from Pivotell , Medimax , Lifemax , TabTime .

Before using any devices where medicines are stored outside of their original packaging, patients or health and social care professionals should consult a pharmacist regarding any potential medication stability concerns. Hospital pharmacies may not be familiar with these devices, which can cause confusion and potentially delay discharge.

Pill bottle cap timers feature a number of daily alarms that automatically indicate the last time the bottle was opened, time of day, am or pm, and day of week. Some caps also fit onto a standard 33mm thread pill bottle but are not child proof.

There are a large number of medication reminder smart phone applications (‘apps’) available with more being developed. Most work by prompting the user to take their medication at specific times of the day through a reminder notification.

Evidence suggests that people tend to link medicines taking with activities rather than times, and that people often need multiple cues. Current evidence that the use of medication reminder smart phone applications is linked to improved adherence is modest or inconclusive. The quality and integrity of information in these apps can vary and some have been criticised for presenting inadequate or inaccurate health information which may deviate from evidence-based recommendations as well as violations of privacy.

Features of better quality apps are:

• reliable content
• availability in Android and iOS
• text or other medication recognition systems,
• alerts for caregivers and useful features such as capacity to schedule dosing regimens and back up capabilities

However, some of the ‘convenient’ features might introduce risks and patients may want to look at some options before deciding on one which could help them.

Print this page

The Top Medication Reminder Apps for Patients

Nonadherence impacts health outcomes, health care costs, and quality measures. Are mobile apps the way to increase adherence rates?

Helping patients stay adherent to their medication is one of the top ways pharmacists can improve quality measures, health outcomes and decrease overall health care costs. When patients miss doses of their medications, the medications do not work properly and mortality and morbidity increases.

It is estimated that 50% of the 2 billion prescriptions filled each year are not taken correctly. 1 Among patients, forgetting is the most frequently reported reason for nonadherence. 2

Some strategies for improving adherence include providing education, engaging social networks and setting reminders or automated alerts such as on a smartphone or app. A study recently published in the Journal of Medical Internet Research 3 showed that mobile apps help to improve medication adherence, even for older adults who may lack experience with smartphones, computers or the internet.

There are a myriad of apps available to help patients remember to take their medications. The research carried out by the University of Arkansas for Medical Sciences 5 identified 461 medication adherence apps on the iTunes, Google Play, and Blackberry marketplaces. The study identified these apps as the most trustworthy:

1. Mango Health (free). The app features a schedule for creating reminders, drug interaction warnings, refill alerts, and a diary. There is also a gamified points system; take your medication and earn points, earn enough and you could win prizes.

2. MyMeds Medication Management (free). MyMeds can send reminders by email and text, as well as push notifications if you’d rather receive info in your inbox. It also has a feature that helps you become more informed about why you are on certain treatments. One of the biggest perks is that it enables you to invite family, friends and your health care team to view and help with your progress.

3. MediSafe Meds and Pills Reminder (free). MediSafe can be integrated with HealthKit (iPhone) to keep track of blood glucose, blood pressure, and weight and can even save reports as PDFs. The app also helps users discover more about food and drug interactions. There’s also a fun side to this offering too, though. How about setting your alert tones so Darth Vader or Austin Powers tell you when to take your meds?

4. Dosecast Medication Reminder (free). Dosecast has a wide range of sounds and options for their notifications: repeating signals after a certain time, continuous signal lasting as long as you do not hear and do not come running to turn it off, and even a postpone option. With this app you can schedule your medication daily, weekly or monthly and set maximum number of allowed doses to avoid dangerous overdoses. Dosecast tracks remaining quantities of your medicines, sends refill reminders, and logs medication adherence.

So the next time you are counseling a patient, why not encourage them to incorporate and utilize a mobile apps to improve patient adherence? When we can encourage patients to create an automated reminder, they will be more likely to be adherent and reach their health goals.

1. Patient Compliance Medication Adherence: Statistics & References. http://www.cadexwatch.com/compliance.html.

2. Boskovic J, Leppee M, Culig J, Eric M. Patient self-reported adherence for the most common chronic medication therapy. Scand J Public Health . 2013;41(4):333—335. [ PubMed ].

3. Mira, J. A Spanish Pillbox App for Elderly Patients Taking Multiple Medications: Randomized Controlled Trial. J Med Internet Res . 2014;16(4).

4. O’Dea, N. Medication Reminder Apps That Think Outside The (Pill)Box. https://thesocialmedwork.com/blog/6-medication-reminder-apps-that-think-outside-the-pillbox .

5. Heldenbrand, Seth & Dayer, Lindsey & Renna, Catherine & Shilling, Rebecca & Martin, Bradley. (2015). Navigating the Flooded Adherence App Marketplace: Rating the Quality of Medication Adherence Apps.

CMS Announces Negotiated Prices for 10 Drugs Under Inflation Reduction Act

Public Health Matters: Walmart is Elevating Specialty Pharmacy Services and Enriching HIV Care

Pharmacists Can Suggest B Vitamin Intake to Treat Parkinson Disease

Pharmacy Focus: What to Know About Medication and Summer Travel

From Hesitation to Vaccination: Tackling Vaccine Hesitancy

Data Show Fremanezumab Converts Chronic Migraine to Episodic, Improves Quality of Life for Patients

2 Commerce Drive Cranbury, NJ 08512

609-716-7777

Products for Independent Living

Questions? Call 800-522-6294 | Contact Us

FREE domestic shipping on Web orders over $75

Talking Monthly Medication Organizer Alarm- Low Profile

Never miss a dose of your important medications.

• Organizes pills for a full 31 days supply of medication
• Talking Alarm Clock Calendar reminds users to take medicine up to 4 times daily
• Date and dosage time verified through LCD display and audible alert
• 'Loud' and 'Extra Loud' settings ensure alarm is heard
• Clear, large-type display makes viewing day, date, and time easy

Related Products

Submit your email address for special promotions and offers.

US6152067A - Medication dosage reminder device - Google Patents

• USPTO PatentCenter
• USPTO Assignment
• Global Dossier

Classifications

• G — PHYSICS
• G09 — EDUCATION; CRYPTOGRAPHY; DISPLAY; ADVERTISING; SEALS
• G09F — DISPLAYING; ADVERTISING; SIGNS; LABELS OR NAME-PLATES; SEALS
• G09F11/00 — Indicating arrangements for variable information in which the complete information is permanently attached to a movable support which brings it to the display position
• G09F11/23 — Indicating arrangements for variable information in which the complete information is permanently attached to a movable support which brings it to the display position the advertising or display material forming part of rotating members, e.g. in the form of perforations, prints, or transparencies on a drum or disc
• A — HUMAN NECESSITIES
• A61 — MEDICAL OR VETERINARY SCIENCE; HYGIENE
• A61J — CONTAINERS SPECIALLY ADAPTED FOR MEDICAL OR PHARMACEUTICAL PURPOSES; DEVICES OR METHODS SPECIALLY ADAPTED FOR BRINGING PHARMACEUTICAL PRODUCTS INTO PARTICULAR PHYSICAL OR ADMINISTERING FORMS; DEVICES FOR ADMINISTERING FOOD OR MEDICINES ORALLY; BABY COMFORTERS; DEVICES FOR RECEIVING SPITTLE
• A61J7/00 — Devices for administering medicines orally, e.g. spoons; Pill counting devices; Arrangements for time indication or reminder for taking medicine
• A61J7/04 — Arrangements for time indication or reminder for taking medicine, e.g. programmed dispensers

Definitions

• the present invention relates to a device for reminding a patient to take his next dose of medication. More specifically, the invention provides a very simple clock-like visual representation of the time when the last dose was taken or the time when the next dose is due.
• Modern medicine has produced a number of powerful and beneficial medications, including drugs to combat cystic fibrosis, heart disease, cancer, and AIDS. However, it is usually important that these drugs be taken at prescribed intervals; the drugs can be ineffective or even dangerous if taken at the incorrect time.
• U.S. Pat. No. 3,921,568 granted to William Joseph Fish on Jul. 25, 1973 for a, "Self Adhering Medication Time Reminder,” describes a six part device mountable on a medication container. Some of these parts are made of plastic and some are made of metal. The rigid construction of the device permits it to engage only flat surfaces such as the top of a pill bottle lid, a location where it might be jarred or damaged when the patient removes the lid.
• U.S. Pat. No. 5,271,353 granted on Dec. 21, 1993 to Gerard Besthorne describes a clock-like device which is attached to the side of a medicine bottle by means of a V-notch cut in the back of the device and an elastic strap which encircles and engages the bottle.
• the device has eight parts and adds greatly to the overall size of the bottle, making it difficult or awkward to place the bottle in one's pocket or purse for use outside of the home.
• What is needed is a device which is so simple in form and so cheap to produce that it could be economically inserted into a medication container by a pharmaceutical company or dispensed as a courtesy by a pharmacist with a prescription.
• the device should be so inexpensive that a patient would not hesitate to throw it out with the empty container and the pharmacological leaflet when his medication is finished.
• this product would be made entirely out of sheet material, such as paper, cardboard or plastic, making production of the device more akin to publishing than to manufacturing.
• the present invention is directed to such a device.
• the invention is a medication dosage reminder device constructed in two pieces from sheet stock such as paper, cardboard or plastic.
• the first piece is a hub having an indicator pointer.
• the second piece is an annular dial having clock markings. When the dial circumscribes the hub, the indicator pointer and the clock markings form a reminder indicating either the time at which the last dose was taken or the time at which the next dose is due.
• the hub may be adhesively fixed to a medication container such that the dial is free to rotate about the hub.
• a device mountable on a surface, for indicating the time at which a task was last completed or is next due, comprising: a sheet member having a central aperture and adapted to abut the surface; a hub having a diameter greater than the diameter of the central aperture of said sheet member; means for fixing a portion of said hub to the surface through the central aperture of said sheet member such that said sheet member is retained against the surface but is free to rotate about said hub and said fixing means; and co-operating indicia on said hub and said sheet member for indicating a time.
• said hub further includes a first pair of opposing protrusions extending radially outwards from the periphery of said hub and adapted to oppose the surface and to constrain said sheet member against the surface.
• said hub further includes a second pair of opposing protrusions extending radially outwards from the periphery of said hub and adapted to oppose said first pair of opposing protrusions such that said sheet member is constrained between said first and second pairs of opposing protrusions.
• Said sheet member and said first pair of opposing protrusions may be flexible.
• a device for indicating one member of a set comprising: a sheet member defining a central aperture; a hub having: a central pivot having a diameter less than the diameter of the central aperture in said sheet member; a first pair of opposing protrusions extending radially outwards from the periphery of the pivot and having a span greater than the diameter of the central aperture in said sheet member; and a second pair of opposing protrusions extending radially outwards from the periphery of the pivot and having a span greater than the diameter of the central aperture in said sheet member, the second pair of opposing protrusions being deformable away from the plane of the pivot such that the first and second pairs of opposing protrusions define between them a discrete annular channel adapted to receive for rotation therewithin said sheet member such that the central aperture of the sheet member encircles the pivot; and co-operating indicia on the hub and the sheet member for indicating one member of the
• the co-operating indicia includes: an annular arrangement of set members on said sheet member and a pointer on the pivot of said hub adapted to point to any one of said set members.
• the co-operating indicia includes: an annular arrangement of set members on the pivot of said hub and a pointer on said sheet member adapted to point to any one of said set members.
• the device further includes means for affixing said hub to a surface such that said sheet member may rotate thereabout.
• the device further includes means for affixing said sheet member to a surface such that the pivot on said hub may rotate within the central aperture in said sheet member.
• FIG. 1 is a perspective view of a medication dosage reminder device embodying a first aspect of the invention, the device being mounted to a medication container which is not part of the invention.
• FIG. 2 is a front view of the device of FIG. 1;
• FIG. 3 is a front view of the hub of the device of FIG. 1;
• FIG. 4 is a rear view of the hub of the device of FIG. 1;
• FIG. 5 is a front view of the dial of the device of FIG. 1;
• FIG. 6 is an exploded rear perspective view of a medication dosage reminder device embodying a second aspect of the invention.
• FIG. 7 is an exploded perspective rear view of a medication dosage reminder device embodying a third aspect of the invention.
• the reminder device 100 is formed from two parts: an annular dial 102 and a cruciform hub 104.
• the dial 102 and the hub 104 are preferably formed from flexible sheetstock such as paper, cardboard, or plastic and may be punched, cut, or similarly formed; however, more rigid material or material otherwise formed would also work in many applications.
• the hub 104 has two longitudinal tabs 106a, 106b, and two lateral tabs 106c, 106d which define at their intersection a pivot 108 having a diameter 110.
• the rear surface 118 of the hub 104 retains a strip of adhesive 120 extending along the lateral tabs 106c, 106d. This adhesive strip 120 serves to attach the hub to a medicine container C, not part of the invention.
• a scale 124 representing time of day.
• the time scale 124 preferably includes indicia for clearly distinguishing A.M. from P.M. times.
• a central aperture 126 passing through the dial 102 and having a diameter 128 which is slightly larger than the diameter 110 of the hub 104.
• the dial 102 is rotateably mounted on the hub 104, sandwiched between the tabs 106. Specifically, the front surface 112 of the lateral tabs 106c, 106d abuts the dial 102 and the rear surface 118 of the longitudinal tabs 106a, 106b abuts the dial 102 such that the dial 102 is locked onto the hub 104 but remains free to rotate about the pivot 108.
• the dial 102 and the hub 104 are somewhat frictional such that they will not rotate one their own accord but only under the control of the patient or some other user.
• the patient places a reminder device 100 on each of his medication containers C by securing the rear surface 118 of the hub 104 to the container C with the adhesive strip 120, the lateral tabs 106c, 106d embracing the container C and conforming to its exterior surface to increase the available mounting surface area.
• the patient then deforms the longitudinal tabs 106a, 106b in order to slip both of them through the central aperture 126 in the dial 102.
• the patient locks the annular dial 102 onto the pivot 108.
• the patient has two options.
• the patient might use the device 100 to indicate the time for his next dose if, on taking the previous dose, he advanced dial 102 so the hub "NEXT DOSE" indicator 114, 116 and the time scale 124 indicate the correct time for the next dose.
• a second embodiment 200 of a medical dosage reminder device is illustrated.
• the new hub 204 is similar to the original hub 104 except that the new hub 204 has two longitudinal tabs 206a, 206b but no lateral tabs.
• the annular dial 202 is adapted to be rotateably held against the medication container C, sandwiched between the rear surface 218 of the two tabs 206a, 206b and the container itself with the adhesive strip 220 replacing the pivot 108 found in the first embodiment.
• this second embodiment 200 might be simpler to manufacture and set-up than the first embodiment 100 but that the first embodiment 100 might be more robust because that pivot 108 keeps the dial 102 from slicing into the adhesive strip 120 and the lateral tabs 106c, 106d provide a larger surface area for engaging the container C.
• a third embodiment 300 of a medical dosage reminder device is illustrated.
• the new hub 304 is similar to the original hub 104 except that the new hub 304 has no tabs but instead has a diameter 330 greater than the diameter 328 of the central aperture 326 in the dial 302.
• the annular dial 302 is adapted to be rotateably held against the medication container C, sandwiched between the rear surface 318 of the hub 304 and the container C itself with the adhesive strip 320 replacing the pivot 108 found in the first embodiment. It can be appreciated that this third embodiment has similar advantages and disadvantages as the second embodiment.
• the dosage reminder device 200, 300 would be installed by abutting the dial 202, 302 against a surface of the medication container C and then placing the hub 204, 304 over top of the dial 202, 302 such that the adhesive strip 220, 320 passes through the central aperture 226, 326 in the dial 202, 302 and engages the container C.
• This arrangement lends itself to mechanization such that the dosage reminder device 200, 300 could be attached during the medicine packaging or labelling process by a pharmaceutical company.
• the dosage reminder device 100, 200, 300 is preferably made of relatively flexible material. This characteristic and the relatively loose connection between the dial 102, 202, 302 and the hub 104, 204, 304 permits the dosage reminder device 100, 200, 300 to work even while wrapped around curved surfaces. Therefore, the dosage reminder device 100, 200, 300 might be placed on a medication bottle itself, instead of on the bottle cap, so that it is more visible and less subject to damage caused by manipulating a "childproof" push and twist cap.
• the specific shape of the hub and dial may be varied so long as one is fixable to the medication container and the other can rotated thereabout while being otherwise retained in place. It is therefore contemplated that a different number or configuration of tabs could be used and that a different shaped aperture could be used.
• time indicia could be placed on the hub while the indicator arrow could be placed on the dial.
• the time scale might be set in minutes, hours, days, weeks, or any larger or smaller interval. It is still further contemplated that the device might find use in non-medical applications where tasks are repeated at intervals and a simple and handy reminder device would be of assistance. It is even further contemplated that a different scale might be used to represent members of a set other than the quantity time, for example people, places, or things.
• the adhesive strip could include any affixing means including various chemical adhesives, magnets, and mechanical couplers and fasteners.
• Engineering & Computer Science ( AREA )
• Health & Medical Sciences ( AREA )
• Physics & Mathematics ( AREA )
• General Physics & Mathematics ( AREA )
• Theoretical Computer Science ( AREA )
• Medical Informatics ( AREA )
• Life Sciences & Earth Sciences ( AREA )
• Animal Behavior & Ethology ( AREA )
• General Health & Medical Sciences ( AREA )
• Public Health ( AREA )
• Veterinary Medicine ( AREA )
• Medical Preparation Storing Or Oral Administration Devices ( AREA )

Description

Claims ( 11 ), priority applications (3).

Applications Claiming Priority (2)

Publications (1)

ID=25679477

Family applications (1).

Country Status (3)

Cited By (37)

Families Citing this family (2)

Citations (14)

• 1997-07-08 CA CA002210084A patent/CA2210084C/en not_active Expired - Fee Related
• 1998-06-30 US US09/110,380 patent/US6152067A/en not_active Expired - Fee Related
• 1998-07-03 GB GB9814501A patent/GB2327138A/en not_active Withdrawn

Patent Citations (14)

Cited By (58)

Also Published As

Similar Documents

Legal Events