Aging in Place: Medication Mischief Managed

Medication concerns are among the most common to cause people to consider or choose institutional care.  Failure to manage medication properly can lead to negative outcomes, disability, and loss of life.  The concerns are well justified.  Medication non-adherence (not filling prescriptions or missing dosages)  results in 10% of hospitalizations, 125,000 deaths, and costs the healthcare system up to $300 billion/year.  Consider that 1 in 5 Medicare patients are re-admitted to the hospital within 30 days after discharge – half of them because of medication non-adherence. In a study by Walgreens, researchers found that every 1% improvement in adherence saves about $50 in healthcare spending.

Technology and modern service-oriented solutions, however, increasingly offer medication management solutions.  Free apps, like Pill Reminder (iPhone) and PillsOnTime (Android) track doses to prevent non-adherence to a prescribed regime. Tracker by Medisafe (iPhone and Android), not only reminds you when it’s time for a refill but enables you to track vitals like blood pressure. Davis’ Drug Guide (iPhone) even contains detailed drug information for patients who have questions about a drug, the possible side effects, or its interactions with other medications.  Traditional retail pharmacies such as CVS, offer packaged medication helping to ensure that patients don't accidentally exclude a medicine from the regime.

For some individuals, a plastic 7-day pill container provides enough structure to enable them to manage their medications. For those who need additional help, technology-enabled containers help prevent both missing a dose or taking the wrong pill. Units are easily connected to the Internet for communication to caregivers about whether the unit was opened at the right time.

Some examples of possible solutions include:

• Tabtime Vibe Vibrating Pill Timer Reminder is a more modern version of the classic plastic pill case.  For less than $20, the Tabtime Vibe Vibrating Pill Timer Reminder has five compartments with different alarms that beep and vibrate when it’s time to take your medicine.

• PillPack (recently acquired by Amazon) delivers  packaged medication doses and has an accompanying app to track information about them. 

• Traditional retail pharmacies such as CVS offer packaged medication. 

• TabSafe is a dispenser and management system that  reminds the user, dispenses medications, alerts caregivers before a dose time is missed, and monitors adherence. TabSafe advertises that it improves medication adherence to over 96%.

• MedMinder is  an automated dispensing box that can be pre-loaded by the pharmacy.

• Guardian Angels HomeCare Medication Dispensing Management Solution (Personal Medication System) will automatically dispense medication and vitamins in accordance with your prescribed treatment program. This device is a low-cost, practical solution to ensure patients get the right dose of medications at the right time. When medicine is not taken within 30 minutes of the prescribed time, a care center is notified. A. representative will call to remind the patient to take their medicine. If the representative does not get a response from the patient, a caregiver or medical contact is then called to ensure adherence.

•  Philips Lifeline Automated Medication Dispensing Service permits a caregiver to load up to 40 days of doses which are dispensed in small cups at a cost of $59.95 per month.

The cost of these solutions are surprisingly reasonable. PillPack and MedMinder, for example, charge just the co-pay medication cost.  Regardless, there is little question that the peace of mind, security, and safety afforded these solutions are well worth the expense.