Medication prescription adherence and the banking problems of 80 and 90 year-olds

Categories: Latest News.

Two excellent, informative and thought-provoking articles in this month’s newsletter from the The Centre for Usable Home Technology (CUHTec): The Role of Technology in Improving Medication Prescription Adherance[sic] by Kevin Doughty and Accessible Digital Banking The Needs of Eighty and Ninety Year Olds by Andrew Monk. Download it here (PDF) and sign up for your own copy of the newsletter for next year! [These articles deserve wider circulation, so click on the item title above and use one or more of the ‘Share’ buttons.]

Comments

  1. As Kevin points out in the Newsletter, taking the correct medication at the correct time is very important in managing one’s own health. Any way adherence can be improved must be beneficial.

    It is likely that adherence to taking medication will not only enable the individual to maintain their ability to be able to live independently within their own home but will also have a positive financial impact on health and social care services.

    As Kevin mentions, reminder devices are low cost, it is how these reminder devices are used to best effect that is the key to their successful use. Telecare can also provide reminders via the Lifeline phone. It seems to me that providing medications reminders f.o.c. by health/social services would be cost effective by avoiding expensive hospital admissions/residential care and in line with government aims.

    It is important in the case of dementia that they are introduced at an early stage to develop a pattern of behaviour. Eventually however, the progress of dementia will mean that reminders will not continue to be of use.

  2. Mike

    You’re right – simple medication reminders can be hugely effective but this is something many telecare operators haven’t picked up on. I know this because..

    A small number of UK monitoring centres were recently invited to pilot our Pellonia Lite platform which offers medication prompting and more, almost entirely free of charge in return for constructive feedback…

    Details are at http://www.pellonia.com/lite

    Although we’ve had an excellent response from many of them, just as many monitoring centres responded with something like “medication or reminder services is nothing we’d ever want to run from our monitoring centre”…

    This was a strange response given some of them were council owned monitoring centres and we had already been contacted by social services at those councils seeking those services. Seems that some monitoring centres are missing a trick and are ignoring the needs of other group departments and a revenue opportunity.

    We have been providing telephone based medication reminder services since 2004 so have a great deal of experience in this field now, if any readers would like some free advice and input about this please just get in contact with us.

    Regards

    James Batchelor
    james@pellonia.com

    http://www.pellonia.com
    Safety Confirmation, Reminders and more

  3. Kevin Doughty

    I’m pleased that the subject of medication adherence has attracted so much interest.

    Perhaps I didn’t emphasise in the article that forgetting to take a medication is only a part of the problem, though perhaps the dominant one for people with cognitive impairments. Consequently, while a simple reminder, whether through the telephone, a text message or an alarm on a watch, may suit some people, there remains a sizeable minority who need rather more support in sticking with their medication regime. They are the ones for whom more sophisticated technologies are required to prevent them overdosing when they receive a reminder, and for whom continuous monitoring is required so that there is feedback available to show how well they are doing.

    The challenge for prescribers is, as always, in assessing the needs, risks and motivations of individuals, and then having a toolbox of options available to choose from depending on their personal features and well-being. Matching the technology to the individual is a professional skill that many OTs possess and which can be improved with practice but also with access to the latest devices or the type described in the article (and in the Telecare EPG). The simplest, and lowest cost, should be the starting point for many – but for more complex cases, I would predict that some time in the future medication may be taken transdermally, perhaps through tattoos or digital plasters that are activated by wireless signals at the appropriate times.

  4. We have been working with Essex County Council for over a year now specifically to tackle medication compliance.

    They pulled together a very good document for all their staff to show the 8 solutions that they recommended, and what scenarios they are suitable for.

    Gary Raynor was the person to pull all this together, and it’s had a positive impact.

    Quite like you say Kevin, simply reminding people doesn’t work for everybody. I wouldn’t say it was the minority when you include those outside the FACS as well, it is a minority of those who are at a Substantial or Critical level, but we get a majority of people using our service who have fell within the low/moderate bracket and can’t get public funded care.

    We also have a lot of requests to supplement other services, and have a close relationship with Pivotell as we get a number of people ask for their pill dispenser with our calls, their minifone with our calls (they can go to the minifone) and many pharmacies we work with, when they sell a dossette box, encourage the use of our service too.

    Great newsletter and look forward to more of them.

    Jamie Cole
    http://www.telecaretechnology.com

  5. Kevin Doughty

    Glad that you liked the newsletter Jamie – we’ve been producing them quarterly for the past 8 years, so it’s nice when they are appreciated.
    The principles of prompt, assist or administer are well established in adult social care but the costs are becoming prohibitive as the population ages and individuals have medication to support multiple morbities. Assistive technology and telecare have to be the answer, but perhaps it is only the prompting element that is currently being managed thanks to various automated approaches. They will remain the first line of defence but I suspect that their effectiveness may be time-limited as individuals tend to get fed up with repetitive prompts and reminders. Perhaps we need some incentives to be in place so that patients are rewarded for good adherence. How about a Marks and Spencers voucher for not missing any medication for a month? There could be opportunities to cheat – so how about taking medication in front of a camera, either one linked into a set-top box for Skype sessions, or using a smartphone or tablet device to provide both the prompts and the confirmation through an image-based analysis? To be sustainable, we need to use the best technology and to think outside the box.

  6. cathy

    James – one of the barriers for Monitoring Centres delivering the prompt is risk averse policy. The argument goes “we cannot see what the person is actually taking so we may prompt them and they will take the wrong medication … and then we will be sued … “

    If an individual engages a service such as telecaretechnology.com offers then the individual accepts the risk.

    Risk aversion is possibly the biggest barrier to Local Authority and NHS progressing some of the benefits telecare/telehealth can undoubtedly offer and this is particularly prevalent in the areas around medication compliance and GPS Location.

    As already indicated assessment is a key part of achieveing the better outcomes and I agree to a point with a pathway of preferred solutions … with the caveat that it could prevent practitioners thinking about alternatives if they are a better match in a given scenario