Managing complicated drug regimes

30 Mar 2015 3min read

I have an elderly relative who, not uncommonly, is now taking a lot of pills and potions, and in addition to that, her short term memory is beginning to deteriorate.

She has recently moved from using a seven-day pill dispenser to having them handed to her by a full-time, live-in carer. Now that is quite a step, but as far as I can see there is no middle ground. There must be thousands of others out there having the same issues and without the luxury of full-time care. In this instance, her prescription drugs are dispensed freely and there is little, if any, follow up to check if they are being taken correctly or taken at all.

Pill dispensers are a great start, and the blister packs that chemists provide deal with the ‘rubbish in / rubbish out’ problems of loading your own pills into a dispenser, or the ‘fiddling’ with the pack that became an issue in our case. But, they don’t tell you whether to take the pill before or after a meal, or help with important instructions, such as taking a pill which requires you not to lie down for an hour afterwards. These differences make a change in drug regimes very difficult to follow.

There are some ‘smart’ dispensers that beep to remind the patient, and alarm to warn of non-compliance, but again in my experience, anything with electronics and buttons, however simple, can quite easily exasperate someone and end up being misused. My relative cannot resist pressing buttons if they are there to be pressed and not necessarily at the right time or in the right order.

Some of these solutions are useful for long term, steady state medication, but fall down with short term courses of antibiotics, or when a dosing regime is being worked out over several months. And they don’t begin to deal with long term compliance of patients who think, “I don’t need to take that any more.” And then there are eye drops…

All of this leads me to ask, how can we help elderly patients with complicated and changing drug regimes whilst at the same time reassure them to not fret about compliance? Can we replicate the human interaction which is the only method that works for someone like my relative?

I don’t have any perfect answers but this need is only going to increase.