Spring 2022 Newsletter
By Sarah Emison, Pharm.D. and Lisa C. Hutchison, PharmD, MPH, BCPS, BCGP
University of Arkansas for Medical Sciences (UAMS) College of Pharmacy
Many older adults have difficulty taking their medications every day at home. With chronic health conditions, daily medications are an important part of staying healthy just like eating a balanced diet and exercising regularly. Forgetting to take medications that are needed increases the risk of disease flare-up, hospitalization, and nursing home admission. Clinicians need to stay current on the options to help older adults stay independent in their homes or reduce the burden on caregivers.
A key factor in managing medications at home is to maintain a current list. This list should include all prescription medications as well as any medications a patient is taking without a prescription including over-the-counter medications, dietary supplements, vitamins, and herbal remedies. The medication name, dose, and directions should be included. The patient or caregiver should be educated on what each medication is for as well as how to take it and what should be expected, both therapeutic and adverse effects. It may be helpful to write this information on the medication list as a reminder or a reference. The patient/caregiver should keep this list in a convenient location such as a wallet or purse for when they have a doctor’s visit or an emergency. (Zonsius 2022)
The second factor in managing medications at home is to have a way to keep track of administration. Simple options include a calendar to mark off when medications are taken, or a daily administration record. They are available from some pharmacies, doctors’ offices, and the Internet, or a person can create their own. These charts can be posted on the refrigerator or other convenient location. Another option is a talking alarm which can be set to provide a reminder of when it is time to take your medication. See Figure 1 for examples of charts and alarms. People with smart phones can download an app which will provide reminders and allow tracking of when medications are taken. Some examples include MediSafe and DoseCast. (Treichler 2022)
Pill containers are another option that help a patient that just needs to see if they have taken their medications (or not) each day to help keep track. Also, they can be filled ahead of time by caregivers so a person can maintain independence with taking medications each day. These containers come in a wide variety. Most recognized are weekly containers with openings for 7, 14, or 30 days. These can be filled with medications that are needed for each day. Other pill containers are arranged with 4 administration times for each day of the week. (Figure 2)
Some high-tech products provide automatic dispensing of the medications when it is administration time. Alarms sound when it is time to take the medication so the patient can press a button for the tablet(s) to be dispensed. In this way, they prevent a person from opening up the containers when it isn’t time to take their medication. In addition, some can be connected to the Internet to allow monitoring of medication dispensed remotely by caregivers who can’t be present for each administration time. (Figure 3)
Individuals with low vision may benefit from larger print prescription labels. These can be request from most pharmacies. Pill containers as discussed above are often labeled in Braille for the days of the week or administration times. Other options are gadgets have been developed which are attached to prescription bottles or use a reading device programmed to provide talking prescription instructions.
Many pharmacies provide services that can be helpful in managing medications at home. Pill packing services involve preparing a blister pack for each administration time for medications. Often these are provided without additional charge. Pill packing services can be arranged by some local community pharmacies, particularly stores that are independently owned. Some mail order pharmacies also provide this service.
Another important service that community pharmacies provide is medication reconciliation and comprehensive medication review. As the number of prescriptions and over-the-counter medications a patient takes increases, it becomes more likely that a medication is continued that is no longer needed, a drug-drug interaction is occurring, or administration instructions get confused between different medications. Pharmacists are trained to review each medication to determine if any of these concerns are occurring and can work with providers to assure a patient is on an optimal medication regimen. Having fewer medications to take is another way to help with managing medications at home. A medication reconciliation and review is recommended for all older adults each time a medication is prescribed. (LeBlanc 2015)
In conclusion, health care professionals need to be aware of the many options for helping patients manage medications at home. Medication education and reconciliation go hand-in-hand with tools and devices designed to keep medication administration safe and convenient for our older patients.
Figure 1: Examples of Alarms and Charts
Figure 2: Pill Container Examples
Figure 2: Automatic Pill Dispenser Examples
LeBlanc RG, Choi J. Optimizing medication safety in the home. Home Healthcare Now, 2015; 33:313-9
Treichler C. The 10 best medication reminder apps for 2022. Onlinedoctor January 16. 2022. https://www.onlinedoctor.com/best-medicine-reminder-apps/ . Accessed April 12, 2022.
Zonsius MC, Myftari K, Newman M, Emery-Tiburcio EE. Optimizing older adults’ medication use. AJN, 2022; 122:38-43.