Danger in switching to pill organisers

Have you ever had one of those days when you get home from work and can’t remember anything about the drive back? I certainly have. click to enlargeYour mind is so engrossed on that knotty problem or you’re busy with a conference call.  Being on auto-pilot, we call it.

Now, we all probably know one or more people who take regular medication and use a pill organiser to help remember whether they took their medicines. When one is taking regular medication it becomes so second nature that one is sometimes on auto-pilot and without some means of checking like using a pill organiser it is so easy to lose track of whether one had the tablets at lunchtime.

Yesterday a report was published in the British newspaper, The Telegraph, about research carried out on the impact of using pill organisers and the results were rather surprising. When people who had not previously used pill organisers were switched to use organisers researchers observed that patients using the organisers were having more medical problems than a control group. Problems such as falls and hypoglycaemic episodes. What was going on?

The explanation, according to one of the researchers, Dr Debi Bhattacharya of the University of East Anglia, England, is that when patients take medication directly from the traditional packaging such as boxed blister packs or pill bottles they tend to occasionally miss a dose. When they switch to a reminder system like a pill organiser, the patient is likely to take their full dosage all the time, thus suddenly effectively increasing their dose. To make matters worse, when a patient who is occasionally missing their dose presents themselves to the doctor, the doctor sees less than the expected improvement and is likely to increase the dosage. Then a switch to a pill organiser can create an overdose with results such as hypoglycaemia.

“Between 1995 and 2010 the number of adults taking five or more drugs per day doubled to 20%, so we are seeing a huge amounts of people taking lots and lots of medication” says Dr Margaret McCartney, a Glasgow GP, “A quarter of people over 80 are on 10 or more drugs”.

The value of using a simple system like a pill organiser to manage these medication is well recognised. However, according to the Telegraph, the UEA team estimate that only 35 per cent of people over 75 who are on three or more drugs use a pill organiser. What the research shows is that the period when switching from dispensing from traditional packaging at every medicine intake to a system like a pill organiser that helps remind to take medication (and check if the medication was taken when on those auto-pilot ocassions) is the likely period for having medical issues.

It is interesting to note that in the UK now all the major pharmacy chains offer a service to produce a personalised blister pack with all of one’s medications for each medication time packed into a separate section in the pack. Typically the pharmacy can provide such packs for medications up to four times a day, and a blister pack would cover a week with each section marked with day and time of day. This service is generally offered free of charge to the patients.

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