Medication Reminders Pathways for Referral

1
Medication Reminders Pathways for Referral

• David Andrews
• Worcestershire County Council

2
Medication Reminders Pathways for Referral

• Service User - Identified Need - Has problems
  taking medication
• Forgets when to take medication
• Forgets what medication to take
• Forgets whether medication has been taken
• Has poor vision
• Has poor dexterity
• Is unable to read medication labels
• Hoards medication
• Does not want to take medication

3
Medication Reminders Pathways for Referral

• Service User forgets to take medication
• Have all avenues been considered?
• Would a simple reminder suffice?
• Pill reminder
• Would a voice prompt help?
• Try pendant alarm with voice reminders (up to 6
  per day)
• Home care calls
• Usually costly arguably tie up resources
• May be important to user for contact with others

4
Medication Reminders Pathways for Referral

• User may not be suitable for Telecare referral
  if
• Service User hoards medication or
• Does not want to take medication

5
Medication Reminders Pathways for Referral

• Service User
• Forgets what medication to take
• Forgets whether medication has been taken
• Has poor vision
• Has poor dexterity
• Is unable to read medication labels or
• Forgets when to take medication and other prompts
  are shown not to work
• Consider Automatic Pill Dispenser

6
Medication Reminders Pathways for Referral

• Make sure that all other routes have been tried
  and are known not to work
• Service User Adult Care Plan reviewed?
• Medication Compliance Aids (MCA)
• Dosett box
• Proprietary units (e.g. Boots MDS, Nomad, Manrex,
  VENALINK, etc.)
• Service User Adult Care Plan reviewed?
• Medication review carried out?

7
Medication Reminders Pathways for Referral

• Thoughts on the profile of the Service User
  before taking referral for Pill Dispenser
• Does not reliably take medication at the correct
  time or in the correct dosage
• Is able to hear the alarm, or see the indicator
• Is able to get to the pill dispenser
• Can recognise that the medication is in the
  dispenser
• Is aware that the medication needs to be taken
• Can achieve some carry over of learning
• Is able to lift the box and turn it over either
  one-handed into other hand or into a bowl

8
Medication Reminders Pathways for Referral

• Is the medication suitable?
• Consider the size, quantity and type of
  medication
• Epilepsy e.g. Epilim too large in its foil,
  cannot be removed from foil until ready to take
• Wet medication
• Warfarin some exceptions e.g. someone taking
  meds 4 x daily could have Warfarin included as
  regime may be reviewed on weekly script
• Some meds (e.g. soluble aspirin) may be
  unsuitable due to time constraints consider
  enteric coated check with GP/pharmacist

9
Medication Reminders Pathways for Referral

• Who fills it?
• Family or pharmacy?
• How to train
• Spare carousels
• Operating procedures
• Other constraints/objections

10
Medication Reminders Pathways for Referral

• Is there a requirement to link to the call
  centre?
• Cost implication for both the unit and for
  monitoring
• Increase in number of calls to call centre
• Will the user be disturbed by an alarm call?
• For those with hearing deficit, consider
  alternative alerts
• or can it be used standalone?

11
Medication Reminders Pathways for Referral

• Deployment with Support
• In almost all cases, support is necessary to
  achieve learning success
• Prior to alarm calls at first
• Post alarm calls later
• Goal is eventual withdrawal
• Typically 2 6 weeks
• Reablement, Home Care, family

12
Medication Reminders Pathways for Referral

• Thank you.
• Any questions?