By Shardool Patel
It’s well-known that medication adherence remains a significant issue with patients in all areas of pharmacy practice. The facts, numbers, and trials have been published several times; so restating them is rather redundant and offers no solution on how to manage this problem. Plenty of articles have been published suggesting educating patients, enhancing vial labels, incorporating technology, and synchronizing refills (to name a few) are strategies to increase adherence.
However, let’s be honest, taking a combination of maintenance medications may appear to be overwhelming for patients just by the sheer number of pills and bottles involved. Moreover, with some medications requiring greater than once daily dosing, the risk of non-adherence increases. So, what can we do to help patients out? Two simple words: pill organizers.
Although the idea may seem simple enough, there is actually a broad spectrum of options available for patients interested in using pill organizers. This can involve anything from simple once daily, seven-day pill boxes available at retailers to more advanced medication filling systems such as Medicine-on-Time®. In an ideal world, somewhere in the middle should be a good starting point. So what does this all entail?
One idea is recommending patients to buy four one-week multi-dose organizers (a one month supply) and have them hand it over to the pharmacy technician upon refilling medications. From here, the technician can fill the prescriptions directly into pill organizers based on time of medication doses (such as morning, lunch, evening, and bedtime). Following the fill process, pharmacists can verify what’s in each compartment to ensure proper medication administration and time of dosing. Patients will now have a visual reminder on the pill organizer stating the time of day the medications needs to be taken. To follow legal regulations, a single spreadsheet-list comprised of each medication name, strength, directions, date, and name of the prescriber can be attached to the back of each pill organizer set. In addition, each pill organizer set should include the name and address of the pharmacy.
There are a few key advantages to incorporating such a system. First, adherence can be evaluated by seeing what medications come back in the pill organizer when patients return for the following month’s refills. Second, this allows patients to centralize refills on a single day in addition to the pharmacist verifying all maintenance medications are refilled. Third, patients can take their scheduled medications as a combination-single dose without having to deal with several different vials. Finally, this will ensure that patients are visually reminded what time of day each set of medications should be taken.
In the booming world of medication therapy management, a marketing strategy could be to advertise filling pill organizers while discussing the medications themselves with the patients. For interested patients, they can even fill their own pill organizers with the assistance of the pharmacist to guarantee that they are taking it at the right time each day, while discussing other counseling points. This monthly program would facilitate a great patient-pharmacist interaction, and could serve as a source of revenue.
So from here, scope out your patients who are on several different medications that you think may be good candidates for pill organizers. Talk to them about incorporating a pill organizer, and start watching those adherence numbers go up.
Reprinted with permission from National Community Pharmacists Association in the May 2011 issue of America’s Pharmacist. For more information about NCPA, visit www.ncpanet.org.