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Drug Compliance: Tips For Taking Drugs As Prescribed (Adherence)

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"Medicines will not work if you do not take them according to the instructeions."  In addition, Not following instructions can lead to extra doctor visits,  extra out-of-pocket costs, and even expensive emergency medical care.

To get the full benefit of a drug, it is important to commit to taking your medications as prescribed for as long as needed. This can be difficult, particularly when you have to take a drug or a batch of drugs over a long period of time.

Rather than just rely on will power:

  • It helps to think of the end result you want and keep in mind that the only way to get there is to take your medicines as prescribed. It can also be a major help to look for relationships that will help lend support to taking your meds as prescribed
  • Tell your health care provider about your daily schedule so medications can be prescribed that would be easiest for you to take if there is a choice.
  • Understand whether to take your meds with food or on ampty stomach before a meal, etc
  • Learn what to do about side effects
  • Make it as easy as you can to obtain refills.
  • Ask the people you live with to help you remember to take your meds..

There are a variety of aides that can help. The ones we know about are discussed below. We also include time tested ideas to create your own compliance method.

NOTE:

  • It is advisable to find out from your doctor what to do if you miss a dose. Keep track of missed doses so you can report them to the doctor at your next appointment.
  • If creating a schedule or figuring out how to integrate taking drugs into your day, speak with your doctor, or a social worker to help. 
  • Do NOT take a holiday from your medications or change the way you take them without speaking with your doctor first.

COMPLIANCE HELPERS TO CONSIDER (COMPLIANCE AIDES)

Compliance aides are products that are specifically designed to help remind you when it is time to take your medications, and/or to assist with organizing your medicines in advance. Compliance aides may be purchased at most drug stores or online - or you can create your own.

Following is a list of some of the compliance aides which are available commercially. Next are ideas for do-it-yourself reminders. If none of the alternatives fit your needs, ask your doctor, his/her staff or your pharmacist for advice about which compliance aide or aides may be best for your particular medical and personal situation. (Advocates report that it helps with compliance if you ask that all instructions relating to medications be put in writing.)

TIP: if you decide to put medications in an aide, it is wise to keep one in the bottle in which received so you won't wonder what pill is in what aide. .

Some of the many compliance aids currently available are:

  • Boxes that store pills and have an alarm.
    • At least one version can be programmed with up to 37 alarms from 6AM to Midnight. It features slide-out pill case with compartments to store medications. Available from e-pill Medication Reminders. www.epill.com offsite link Tel.: 800.549.0095
    • The MEDGLIDER System 7 is a portable seven day pill organizer and alarm that allows for four times a day dosing. Choose a beep alarm, a voice that says "time to take your pill" or a blinking light. Available from e-pill,LLC. www.epill.com offsite link Tel.: 800 549 0095
    • MedReady Medication Dispenser stores medication under lock and key. It holds up to seven days' worth and allows for four times a day dosing. An alarm sounds when it's time to take medication, and a single compartment advances for access. Available from Assisted Living Store. www.assistedlivingstore.com offsite linkTel.: 888.388.5862
  • Electronic pill container: A Vitality "GlowCap" is a high-tech top for a standard pill bottle. The cap reminds you when to take a pill. The device can set off an automated telephone or text message reminder to patients who fail to take their pills. It can also generate e-mail or letters reporting to a family member or doctor how often the medication is taken.
  • Individual Packets (also known as Blister Packs)
    • Many pharmacies create daily blister packs instead of putting pills in traditional bottles. Each packet is securely sealed and is waterproof. The packet allows you to carry your meds in single or multi-dose packets. Packets are generally date and time stamped so you can tell at a glance whether the dose has been taken. It also prevents taking a dose more than once. For example,
      • CVS, Rite Aid, Target, Walgreens and Walmart offer the service. So does Moms Pharmacy which primarily works with paients with HIV, but not exclusively. See: www.momspharmacy.com offsite link.
      • An online pharmacy, PillPack, uses platic blister packs at no cost. The service coordinates with your insurance company. It also syncs multiple prescriptions so that they all refill at the same time.
    • Using blister packs is believed to cut down on errors - for instance, taking the wrong drug, or taking the correct drug at the wrong time. This is particularly so if taking more than 4 drugs.
    • Individual packets may come with an additional charge. The charge is not generally covered by health insurance but it is worth checking "just in case."
  • Digital pill dispenser
    • MedMinder.com  offsite linkhas a pill dispenser that is locked until the time comes for medication. (Another type is unlocked.)  A caregiver can remotely program the schedule and see if the user has complied. The dispenser flashes (if locked, it unlocks) when it is pill time. The dispenser beeps if the medicine is not taken. If the beeps don't work, a pre-recorded voice that the user records acts as a reminder. If that doesn't work, the patient gets a call and a caregiver receives an e mail, text or call.
    • Reminder-Rosie.com has a voice activated talking clock that tells you to take your meds at a certain time. Once the medicine is taken, the person either says “reminder off” or touches it to turn it off.
  • Your mobile phone or device. There are various applications for mobile phones which prompt when to take medications. No one application is best. It's worth spending a few minutes to look at the various apps to see which fits your life and lifestyle. For example: 
    • DoseCast (free): For people who take multiple doses of medications on a daily basis. Lets you set reminders according to your own schedule. As you take doses, Dosecast tracks remaining quantities, sends refill reminders and logs compliance
    • HealthPrize (free): Provides prizes to reward good behavior
    • MedHelper (free, plus a small charge for the pro version): Works for simple or complex drug regimens.
    • MediRemind (small charge). Includes contact numbers of your medical team which makes it easy to refill a prescription.
    • MediSafeProject.com  offsite linkalerts you when it is time to take your next dose. The app works for smart phones, regular mobile phones, mobile devices and calls to a landline. If you do not take the dose, it alerts a caregiver, family member or friend.
    • PersonalMD.com has a service you pay for monthly that reminds you about meds by calling you on your cell phone or an e-mail to your pager. The service also reminds you about refilling prescriptions. personalmd.com/medreminder_description.shtml offsite link
    • PillBoxie (free): Designed for visual people
    • RxMindMe (free): Includes different reminders to choose from
    • RX Pal sends reminders about when to take your drugs; alerts you when a prescription is running low and links to your pharmacy for refills
    • Zuri (for iPhones) calls and reminds you which medication you are supposed to take at a particular time. Zuri includes a feature that allows you to note whether you took the medication or not. It also allows your doctor to see your compliance through a separate web page.
  • Watches that remind you when to take medications. For example, a watch from Cadex keeps track of up to 12 daily medications and stores a database of vital medical information. Available from Cadex, Box 22896, Ketchum, Idaho 83340 www.cadexproducts.com offsite link 

TIME TESTED IDEAS TO HELP CREATE YOUR OWN COMPLIANCE METHOD

In order to maintain compliance and keep track of how to take your medications, consider creating an easy to remember system for taking your medications. While the possibilities are only limited by your imagination, here are a few methods that have worked for other people: 

  • Use a multi-box screw box available in your local hardware store can be an inexpensive compliance aid. Group your pills according to day, time and dosage. You can sort your pills every few days or once a week instead of every day, and you can easily see whether the pills for the allotted time were taken.
  • Keep your drugs in sight. If you can see your meds, you are less likely to forget them.
    • For example, if you take a pill in the morning, leave the bottle with your coffee mug or coffee maker. 
    • If the drug has to be refrigerated, keep a Post-it or similar note where you will see the note.
  • Place Post-it Notes on the inside of the bedroom or front door.
  • Put "M"s (for "Medications") on a daily calendar at times you need to take your meds. Cross off each M as you take a pill.
  • Coordinate taking your pills with a daily routine, such as brushing your teeth or watching your favorite t.v. programs.
  • Set an alarm on your cell phone, PDA, watch, or inexpensive pocket alarm.
  • Mary Sloane, 78, keeps track of five medications a day by sorting her pill bottles each evening into separate dishes. One is for morning pills, the other for the next evening. Then she turns each medicine bottle upside down after taking the pill so she can tell at a glance if she has taken it that day. "You have to have a system" Sloane says. "because just as soon as I get started taking my pills, the phone rings, and when I come back to it, I think, now have I taken that?"  (If the bottles have child proof caps, you can accomplish the same thing by placing the day's allotment of each pill on the upside down cap).
NOTE: For additional information see:
  • If you have difficulty swallowing a pill, click here.
  • If a pill melts in your mouth but tastes bad, click here.
  • To learn how to store drugs safely, click here.
  • To learn about renewing prescription drugs, click here.
  • For information about what to do it in insurance carrier insists that you switch drugs, click here
  • It is wise to keep a List of Medicines with you at all times so your doctor or other health care provider will be able to quickly check whether a drug he or she is proposing may interact negatively with a drug you're already taking. The List will also come in handy in case you need unexpected emergency treatment, whether because of your existing health condition or another reason. For a form to use, click here
  • To learn what to do with unused drugs and related supplies, click here.
  • If you experience dry mouth, click here.
  • If you experience mouth sores, click here.

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