dosage medication reminder aids assignment pdf

Dosage / Medication Reminder Aids Assignment pdf

Table of Contents

Dosage and medication reminder aids play a crucial role in healthcare by helping individuals adhere to their prescribed medication regimens. This paper explores the significance of these aids in improving medication adherence and patient outcomes. We discuss the challenges associated with medication non-adherence and the potential consequences of missed doses. Furthermore, we examine various dosage and medication reminder aids, including traditional methods such as pill organizers and alarms, as well as modern technological solutions like medication reminder apps and smart pill dispensers.

By understanding the importance of medication adherence and the available reminder aids, healthcare professionals and patients can work together to promote better health outcomes.

Introduction

Medication adherence is a critical aspect of managing chronic conditions and preventing complications. However, studies consistently show that a significant portion of patients fail to adhere to their prescribed medication regimens. This non-adherence can lead to worsening health conditions, increased hospitalizations, and higher healthcare costs. One of the primary reasons for medication non-adherence is forgetfulness.

People lead busy lives and may struggle to remember to take their medications as prescribed. This is where dosage and medication reminder aids become invaluable. These aids help individuals remember to take their medications on time and in the correct dosage, thereby improving adherence and reducing the risk of adverse health outcomes.

Five Rights of Medication

The “five rights” of medication administration serve as fundamental principles to ensure patient safety and the effectiveness of medication therapy. These rights include:

• Right patient: Ensuring that the medication is administered to the correct patient by verifying their identity using two patient identifiers, such as name and date of birth.
• Right medication: Confirming that the medication being administered is the one prescribed for the patient by checking the prescription label and comparing it to the medication order.
• Right dose: Administering the correct dosage of the medication as prescribed by the healthcare provider, taking into account factors such as the patient’s age, weight, and clinical condition.
• Right route: Ensuring that the medication is administered via the correct route (e.g., oral, intravenous, topical) as prescribed by the healthcare provider.
• Right time: Administering the medication at the correct time according to the prescribed schedule, taking into consideration factors such as the medication’s pharmacokinetics and the patient’s meal times.

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Adhering to these five rights helps prevent medication errors and ensures the safe and effective use of medications.

Remembering for Medications

Remembering to take medications can be challenging, especially for individuals with complex medication regimens or cognitive impairments. Fortunately, there are several strategies and aids that can help improve medication adherence:

• Pill organizers: These are containers with compartments for organizing medications by day and time. Pill organizers help patients keep track of their medications and ensure they take the right pills at the right times.
• Alarms and reminders: Setting alarms on smartphones or using medication reminder apps can help patients remember to take their medications at scheduled times. These reminders can be customized based on the patient’s medication schedule and preferences.
• Associating medication-taking with daily routines: Linking medication administration to routine activities such as brushing teeth or eating meals can help establish a consistent medication-taking habit.
• Involving family members or caregivers: Family members or caregivers can play a vital role in supporting medication adherence by helping patients remember to take their medications, refilling prescriptions, and monitoring for any adverse reactions or side effects.

Some Extra Remembering Aids to Take Medication

In addition to traditional methods, several innovative technologies and devices have been developed to enhance medication adherence:

• Medication reminder apps: These smartphone apps allow users to set up medication schedules, receive reminders, and track adherence over time. Some apps also offer features such as medication refill reminders and medication interaction alerts.
• Smart pill dispensers: These devices dispense medications at pre-programmed times and can be set up to provide audible or visual reminders to take medications. Some smart pill dispensers also offer features like remote monitoring and notifications for missed doses.
• Wearable devices: Wearable devices, such as smartwatches and activity trackers, can be programmed to send medication reminders to users’ wrists. These devices offer the convenience of constant reminders without the need for a separate smartphone or pill dispenser.
• Integrated healthcare platforms: Some healthcare systems and pharmacies offer integrated platforms that allow patients to access their medication schedules, receive reminders, and communicate with healthcare providers seamlessly. These platforms may also offer medication management tools and educational resources to support adherence.

By leveraging these extra remembering aids, patients can personalize their medication management strategies and improve their overall adherence to prescribed regimens.

In conclusion, dosage and medication reminder aids are essential tools for promoting medication adherence and improving patient outcomes. By understanding the five rights of medication administration and exploring various remembering aids, healthcare professionals and patients can work together to overcome barriers to adherence and optimize medication therapy.

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Dose Administration Aid Service in Community Pharmacies: Characterization and Impact Assessment

André vicente.

1 FCS-UBI, Faculty of Health Sciences, University of Beira Interior, Avenida Infante D. Henrique, 6200-506 Covilhã, Portugal; tp.ibu.eduascf@98473a

Beatriz Mónico

2 Holon Pharmacies, 1100-100 Lisboa, Portugal; moc.liamg@ocinomczirtaeb

Mónica Lourenço

3 CIDTFF, Campus Universitário de Santiago, University of Aveiro, 3810-193 Aveiro, Portugal; tp.au@ocneruolacinom

Olga Lourenço

4 CICS-UBI, Health Sciences Research Centre, University of Beira Interior, Avenida Infante D. Henrique, 6200-506 Covilhã, Portugal

Associated Data

The data that support the findings are available from the corresponding author upon reasonable request.

Adherence to therapies is a primary determinant of treatment success. Lack of medication adherence is often associated with medical and psychosocial issues due to complications from underlying conditions and is an enormous waste of medical resources. Dose Administration Aid Service (DAAS) can be seen as part of the solution, allowing individual medicine doses to be organized according to the dosing schedule determined by the patient’s prescriber. The most recent systematic reviews admit the possibility of a positive impact of this service. In line with this background, the study reported in this paper aimed to characterize DAAS implementation in Portugal and understand the perceptions of pharmacists and owners of community pharmacies regarding the impact of DAAS, preferred methodology types, and State contribution. The study was guided by qualitative description methodology and reported using the consolidated criteria for reporting qualitative research (COREQ) checklist. Data were collected through semi-structured interviews with 18 pharmacists and/or owners of community pharmacies. Using qualitative content analysis, we identified categories that revealed that automated weekly methodology is the preferred methodology, because of its easiness of use and lower cost of preparation. However, the investment cost was felt to be too high by the participants considering the number of potential users for implementation in practice. Participants were also unanimous in recognizing that DAAS has a very positive impact in terms of safety and medication adherence, and the majority agreed that it also helped reduce medication waste. Implications of these findings for medication adherence are discussed.

1. Introduction

Older people, defined as those aged 65 years and older, often have multiple chronic health problems that require ongoing monitoring and medical interventions. This, and the increasing supporting evidence regarding multi-drug regimens in the management of these chronic conditions, mean that polypharmacy is often unavoidable in older people [ 1 ]. There are several definitions of polypharmacy, with the most consensual one being the simultaneous use of five or more medications [ 2 ].

Considering these complex multi-drug regimens and the decline in cognitive and physical abilities associated with aging, it comes as no surprise that medication errors often occur and may be responsible for adverse drug events (ADEs), unplanned hospitalizations, and increased morbidity, mortality, and healthcare costs [ 3 , 4 , 5 , 6 , 7 , 8 ]. Therefore, guaranteeing the correct, safe, and effective use of the prescribed medication is one of the greatest challenges faced by healthcare professionals, and is also recognized by the World Health Organization (WHO) as a strategy to tackle chronic health conditions effectively [ 9 ].

Medication adherence is defined by the WHO as “the degree to which the person’s behavior corresponds with the agreed recommendations from a health care provider” [ 9 ]. It is a measure of the person’s ability to accurately follow a prescribed medication regimen.

Non-adherence represents a major risk factor in chronic conditions and has become a large burden in healthcare systems. Non-adherence can be classified into intentional—when a person deliberately decides not to take their medication, or non-intentional—due to forgetfulness, lack of understanding, complexity of the regimen, or physical limitations [ 1 , 10 ].

The development of effective interventions to improve adherence is a challenge many researchers and health professionals have been pursuing for decades [ 11 ]. Various authors suggest that Dose Administration Aids (DAA), especially the medication reminder packaging, may represent a simple method to help tackle non-intentional non-adherence and to help patients better fulfill their treatment [ 12 , 13 , 14 , 15 , 16 ].

A Dose Administration Aid Service (DAAS) consists of repackaging solid oral medication by a healthcare provider, mostly in a community or hospital pharmacy, in order to help patients manage their polymedication [ 10 , 17 ]. DAA are the devices that allow medications to be organized and stored in compartments according to a patient’s dosing schedule. DAA can be grouped into three different categories: reusable multicompartment adherence aids (so-called pillboxes or manually filled dosettes); manual or automated blister packs; and sachet systems [ 10 , 18 ].

Reusable multicompartment adherence aids exist in various shapes and sizes. However, the most commonly used is the 7-day format, with four subcompartments for different times of the day. They can be self-administered by the patient or filled by the caregiver or pharmacy staff, which constitute major advantages, along with its reusability. Nevertheless, there are also some significant disadvantages related to hygiene, stability of the deblistered tablets, and accuracy of manually filled aids [ 10 ].

In manual blister packs, it is a pharmacist who manually distributes the medication into a securely sealed blister pack (or it is an automated system which distributes the medication automatically, in the case of automated blister packs), therefore protecting the medication until administration time. This type of DAA is widely used around the world and the corresponding service is remunerated in several countries. Their manual production is easy and affordable for every pharmacy, though they require the implementation of rigorous quality controls before dispensing to the patient. They also have a reminder function as they allow the patient to visualize the pills that need to be taken and the ones that were already taken [ 10 ].

With sachet systems, medication for a particular date and time of the day are packed in an individual sachet, labelled with the date and time, the medicine details, and the patient’s name. They are rolled up in chronological order and prepared using an automated packing technology. Community pharmacies either outsource this service to a large-scale packing facility, or have installed technology to enable onsite packing, despite the considerable investment associated with the latter [ 19 ]. This service is mainly used for institutionalized patients and when a greater number of patients is considered. In contrast to multi-drug punch cards, sachet systems do not allow for a visual control of the taken medication, and patients (especially ambulatory) need good instructions in order to follow the proper sequence of the sachets [ 10 ].

The most recent systematic reviews admit the possibility of a positive impact of a DAAS on medication adherence, drug safety, clinical outcomes, and reduction of waste. However, these studies also highlight the fact that the existing literature is still limited and susceptible to bias [ 20 , 21 , 22 ].

The aim of this study is, therefore, to characterize DAAS implementation in Portugal and understand the perceptions of pharmacists and/or owners of community pharmacies regarding the impact of DAAS, preferred methodology types, and State contribution.

2. Materials and Methods

2.1. study design.

The study used qualitative research and semi-structured interviews to access the perceptions and experiences of pharmacists and/or owners of community pharmacies regarding DAAS ( Appendix B ). Creswell (2013) [ 23 ] suggests that qualitative research is preferred to quantitative research when health science researchers seek to (a) share individual stories, (b) write in a literary, flexible style, (c) understand the context or setting of issues, (d) explain mechanisms or linkages in causal theories, (e) develop theories, and (f) when traditional quantitative statistical analyses do not fit the problem at hand. In particular, the study used qualitative description, which is considered to be especially amenable to health environments research because it provides factual responses to questions about how people feel about a particular issue, what reasons they have for using particular services or features, and the factors that facilitate or hinder use [ 24 , 25 , 26 ].

2.2. Participants

Participants in this study were 18 pharmacists, that were either technical directors, pharmacists responsible for the service, and/or owners of community pharmacies, who were recruited through convenience sampling. In Portugal, a technical director is the pharmacist responsible for all acts (pharmaceutical services and other) performed at a specific pharmacy. Criteria for study participation were the provision of DAAS for at least six months and having at least one user of this service at the time of data collection.

The sample of community pharmacies was obtained in two ways: (i) through Google ® search, using the keywords “pharmacy” and “dose administration aid service”; (ii) via contact with pharmaceutical groups established in Portugal, which provided a list of community pharmacies that met the requirements and were interested in participating in the study. This process resulted in the identification of 433 community pharmacies, which were approached through direct contact via email and/or telephone. After being contacted twice, a reply was received from 25 pharmacies of which only 18 agreed to participate. The remaining seven pharmacies refused to participate for not having the service available at the time. The geographical distribution of the 18 pharmacies is presented in Figure 1 , encompassing 11 of the 18 districts of mainland Portugal.

Geographic distribution of the community pharmacies.

The pharmacists (technical directors or those responsible for the service) and/or owners of the 18 community pharmacies were interviewed by one of the researchers (AV). The participants’ profile is provided in Table 1 .

Participants’ characterization.

All participants provided their written informed consent to participate in this study and for the publication of data included in this article. The information provided in the consent form explained the objectives of the study, the voluntary nature of participation, the possibility to withdraw from the study at any time, the materials, methods, and procedure to collect and analyze the data, and the anonymity and privacy statements. Ethical review and approval were obtained from the Ethics Committee of the University of Beira Interior (process no. CE-UBI-Pj-2021-004:ID530).

2.3. Data Collection

Data were collected through semi-structured, one-on-one interviews with the 18 pharmacists and/or owners of community pharmacies between 16 March 2021 and 7 July 2021. Interviews took around 40 min and were conducted via videoconference in the participants’ workspaces. All interviews were carried out by one of the researchers (AV) following a guide ( Appendix A ) that was developed based on the phenomenon of interest and drawn from relevant literature [ 27 , 28 , 29 ]. The interview guide included close-ended questions, which covered, for instance, the number of years the pharmacy had been providing DAAS, the number of people using the service, the methodologies available, or the average cost of the service. Open-ended questions were also used to encourage participants to express their personal opinions regarding their preferred methodology or the impact of the service on user safety, waste reduction, and therapy adherence.

The guide was tested for face and content validity by a panel of experts [ 30 ], which included 2 pharmacists familiar with the research subject. The panel assessed the appropriateness and comprehensiveness of the interview guide contents in relation to the aims and the subjects of the study. Question items were also reviewed for readability, clarity, and comprehensiveness [ 31 ]. The experts’ comments were discussed and analyzed critically by two researchers involved in this study (AV and OL) and changes for improvement were negotiated. These included reformulating some items for greater clarity, re-ordering, and adding more questions. To ensure understandability of the questions during the interviews, the participants were given the freedom to raise concerns, skip any question, or even withdraw from the interview at any time during the study without giving reasons. Furthermore, if the question was not properly comprehended, the interviewer explained it in further detail or using alternate expressions.

Considering the ethical and legal issues involved in collecting and retaining visual or audio-recorded data, only field notes were made during and immediately after the interviews. To ensure accuracy and comprehensiveness of the data, the researcher conducting the interviews (AV) made sure to use factual and objective terms, include specific quotes, and refrain from adding his own inferences and beliefs to the interview notes to minimize bias. Furthermore, caution was also taken to ensure that the notes translated participants’ perceptions or opinions by further inquiring along the views they presented. After each interview, field notes were examined and checked for accuracy, legibility, completeness, and clarity by two researchers (AV and OL).

2.4. Data Analysis

Data collected from the field notes were treated using content analysis, a technique commonly used in qualitative research to systematically and objectively analyze words or phrases in text documents. Hsieh and Shannon (2005) present three types of content analysis, any of which could be used in a qualitative descriptive study [ 32 ]. Conventional con-tent analysis is used in studies that aim to describe a phenomenon where existing research and theory are limited; directed content analysis is used in studies where existing theory or research exists; while summative content analysis is used to quantify and interpret words in context, exploring their usage. In this study, conventional content analysis was preferred to the other types of content analysis, considering the dearth of research on DAAS in the Portuguese context and the possibility of gaining direct information from the study participants.

Data analysis started with reading all field notes repeatedly to gain familiarity with the content and obtain a sense of the whole. Then, data were read word by word to derive codes. Firstly, the exact words from the text that appeared to capture key thoughts or concepts related to the participants’ perceptions and experiences were highlighted. Then, notes were taken to document first impressions. As this process continued, an initial coding scheme was created by assigning labels for codes that were reflective of more than one key thought. Codes were then sorted into categories and, later, into subcategories for a more comprehensive analysis. At this stage, a tree diagram was developed to help organize these categories into a hierarchical structure ( Figure 2 ). Exemplars for each category and subcategory were identified to facilitate reporting of the findings. To provide guidance during the reporting of this study, the consolidated criteria for reporting qualitative research (COREQ) checklist ( Appendix B ) was used.

Tree diagram of categories and subcategories.

It is worth mentioning that qualitative content analysis was complemented with statistical analysis, whenever appropriate. This is a common strategy in qualitative descriptive studies if they aim to more adequately or fully describe the participants or phenomenon of interest [ 24 ]. In the case of this study, descriptive quantitative analysis was used to allow for a more thorough characterization of DAAS in Portugal.

2.5. Trustworthiness and Reflexivity

The criteria of credibility, dependability, transferability, and confirmability were used to assess the trustworthiness of the data [ 33 ]. Credibility was ensured through periodical peer debriefing between the researchers to discuss data analysis and findings. To ensure dependability, two researchers (AV and ML) discussed the process of data analysis and codes, making appropriate adjustments as necessary to establish consensus and guarantee consistency. Furthermore, an audit trail of the research process was maintained through detailed documentation of the coding meeting notes, the recruitment protocol, and all field notes taken during and after the interviews. Transferability and rigor were achieved through data obtained from interviews with participants from 18 community pharmacies representing 11 of the 18 districts of Portugal, which allowed for a diverse range of perspectives on the phenomenon under study. To facilitate transferability, the research context, participants, and settings are described in a rich manner. Confirmability was ensured through a detailed methodological description and through reflexivity [ 34 ], meaning that the researchers were aware of their background and position and how these could influence the research process.

Our research team consisted of one male researcher (AV), a master’s student in Medi-cine (AV), and three female researchers (BM, ML, and OL), two non-practicing pharmacists (AV, OL), and a qualitative researcher (ML). Both AV and OL (an assistant professor) have interests in improving medication adherence. AV had taken a graduate study course on qualitative and quantitative research methods, ML has over 15 years of experience as a qualitative researcher, and OL has experience in conducting qualitative research. Throughout the research process, team members discussed their personal views on DAAS. All of the researchers had only a theoretical understanding of DAAS, never having advised or provided the service in a community pharmacy environment. AV conducted the interviews. After every interview, AV and OL appraised the interview, the appropriateness of the questions, and discussed the level of comfort of participants in answering the interview questions.

3.1. Characterization of the DAAS

Table 2 gives an overview of DAAS’ characteristics available in each pharmacy. All pharmacies use manual blister packs, except for one, which uses only automated blister packs ( Figure 3 ). In two pharmacies, automatized sachet systems coexist with manual blister packs. The majority of the pharmacies (16 out of 18) provide DAAS on a weekly regimen. It is important to note that therapeutic reconciliation is a crucial part of the service in all the pharmacies, being mandatory at the beginning of the process and whenever pharmacists deem it necessary.

Methodologies provided. wBP: weekly blister pack; mBP: monthly blister pack; bBP: biweekly blister pack; wSS: weekly sachet system; mSS: monthly sachet system; wAMD: weekly automated blister pack.

Overview of DAAS’ characterization.

ABP: automated blister packs; BP: manual blister packs; DK: do not know; N/A: non-applicable; NR: did not answer; SS: sachet system; * not considering humans resources’ cost.

DAAS has been provided on average for 4.8 ± 2.77 years (median 5 years). The maximum value recorded was 10 years and the minimum was half a year ( Figure 4 ).

Number of years of service provision.

At the time the interviews were made, pharmacies provided the service on average to 11 ± 18.46 ambulatory users and 95 ± 240.66 institutionalized users, showing a high variability ( Figure 5 ). Although data suggest an apparent trend for DAAS to be a service provided mainly to institutionalized users, it is important to emphasize that only half of the pharmacies provide DAAS in this setting and, except for one, all have at least one ambulatory user. It is also worth mentioning that pharmacy C, despite not having institutionalized users at the time of the interview, has previously provided services in this type of facility.

Number of DAAS current users (ambulatory and institutionalized).

Costs for the service are summarized in Figure 6 . For users, the cost is on average EUR 12.91 ± 4.89 per month. The maximum reported value was EUR 20 per month and the minimum EUR 7.5 per month. The average cost for pharmacies was EUR 8.74 per month, considering all the expenses, as reported by 5 out of 18 participants (#2, #3, #7, #13, and #17). Three participants did not know the data to properly answer this question (#4, #10, and #11), one did not want to answer (#15), and eight did not know how to quantify the human resources’ costs (#5, #6, #8, #9, #12, #14, #16, and #18). In pharmacy A, the service is provided as part of an established contract for dispensing medicines. Pharmacy P offers the service cost-free.

DAAS’ cost per month for users and the pharmacies. NR: did not answer; DN: do not know; * not considering human resources’ cost.

3.2. Preferred Methodology

This category captures participants’ perceptions of preferred methodologies and the reasons behind them. Preferred methodologies are those perceived as the best methodologies despite being currently applicable or not.

Although manual blister packs are the most frequently provided methodology, the majority of participants (10 out of 18) believe that an automated methodology is best in terms of convenience because of its easiness of use, and lower cost of preparation ( Figure 7 ). Participant #17 also mentioned the easiness of the expansion of the service as an advantage. However, since “the investment costs are too high for the actual low number of users the service has, it is not practicable”. Participant #16 also added another reason for automation not being feasible, which is the “gratuitousness of the service”. Participant #18 justified the automated choice because “they did not know others”. Six participants preferred the manual methodology because of its easiness of use and one participant (#5) because “they did not know others”. In terms of frequency, a weekly methodology is preferred (13 out of 18) due to a “tighter and more rigorous monitoring by the pharmacist”. Four participants preferred monthly preparation because it was logistically easier for them. One participant (#7) did not commit with a specific answer and mentioned frequency was variable, being influenced by factors such as the “users’ cognitive ability” and “how easy it is for them to go to the pharmacy”.

Preferred methodologies.

3.3. Impact on Safety

In terms of safety, it is unanimous that DAAS improves medication safety amongst users since it “prevents errors” such as “overdose”, “forgetfulness”, “incorrect drug use”, or “wrong time or administration mode”. Participant #9 explored one of the reasons for some of these issues: “There’s a lot of confusion about generics or what is the active substance of each medication or what it’s used for”. Another participant (#10) gave the example of a patient who “stopped having neurologic complications due to medication errors after enrolling in the service”. Participants also added that “pharmaceutical monitoring is a safety net” since there is a therapeutic reconciliation process throughout the service. As participant #6 explained: “Considering that the majority of DAAS’ users are polymedicated, it is understandable that there’s an increase in terms of medication errors and side effects. So, the therapeutic reconciliation made by the pharmacist along with the therapeutic reconciliation made by different prescribers helps to achieve greater safety”. The same idea was stated by participant #10: “The initial ‘medication cleaning’ in DAAS prevents medication errors that users tend to commit”.

There are other reasons that explain the impact of DAAS on safety. For instance, as expressed by participant #9, “the monitoring of important parameters such as blood pressure for a person who is taking antihypertensives, for example, is included in DAAS”. Participant #12 alluded to the fact that “Even in terms of medications’ safety there is an improvement since storage and conservation conditions are guaranteed in a tighter way”. Participants also discussed the “better articulation between the attending physician and the pharmacist”, which can be seen as part of an integrated approach to medical care. As participant #2 explained, there is an “inverse feedback circuit from the pharmacy to the medical doctor about the actual reality of everyday users which allows to complement the care doctors provide, who very often feel they lack time for a thorough evaluation”. Participant #12 added “We discover more medication errors that patients are committing, which really helps in terms of prevention”. Participant #17 summed up the impact on safety and the advantages of the better articulation with the attending physician: “DAAS assures that the patient is not making mistakes alongside their medication (like overdose), that they do not forget to take their medication, that the patient has a qualified professional watchful to every possible medication’s interactions or side effects as well as decompensation of parameters and the arising of different symptoms related to a new health condition. This leads to better care since there’s an anticipated referral to the attending physician on a routine basis or in urgent episodes”.

3.4. Impact on Therapeutic Adherence

All participants were unanimous in stating that DAAS improves therapeutic adherence. One participant even mentioned that they “do not know of a method as good as DAAS to improve therapeutic adherence” (#2). Participant #6 added “I feel it has a significant impact because I can verify in my daily practice that users achieve better health results since there is a greater therapeutic adherence”. Even though there is no reliable data to compare adherence before and after starting the service, DAAS is considered to be a “very significative improvement” and one participant (#2) shared a 97% adherence rate among users. Some pharmacies save an adherence record based on the returned blister packs, which is very useful, however, “it is necessary to insist that the users bring the blister pack back so that adherence can be properly recorded. When patients bring the blister pack back we can check the therapeutic adherence which is very useful to notify caregivers or even medical doctors in some rare cases” (#4). Participant #14 helped to understand why it is often difficult to establish a link with the attending physician: “Although an effective articulation between pharmacists and doctors is crucial to monitor therapeutic adherence, it is not done regularly because the whole system is not designed to make it happen on a routine basis”.

The reasons why therapeutic adherence is improved were also advanced by participant #17, who explained that these are related to the “feeling of security the service provides” and “the commitment that is established”. Nevertheless, according to participant #3, “the system is not perfect because the user needs to know which day it is to know how to comply. However, in those cases, we make sure they do not forget by sending a notification”.

3.5. Impact on Waste

Considering the impact that DAAS has on waste, this is the only topic where there was no unanimity among the participants. The majority (15 out of 18) consider that in terms of medication waste, there is a reduction because the stock control is made by the pharmacy, reducing the accumulation and excessive consumption of medicines. Consequently, “patients do not buy every medicine the prescription has or, at least, in unnecessary amounts, creating pharmacies at home” (participants #10, #11, and #18). Participant #10 added “There is a handover of the medication management to the pharmacist allowing health gains and also financial savings for the State by waste reduction”. Participant #12 gave a personal example: “We have a patient who had 38 packages of medication at home when they first started the service, this was clearly a problem”. Additionally, 10 out of 18 also mention the indirect costs’ effect because the improvement in therapeutic adherence and safety leads to a decrease in health services’ costs. Participant #12 mentioned “The core of this indirect costs’ effect is simply the investment on prevention this service provides”. Nevertheless, participant #11 stated that “Although therapeutic adherence and prevention of errors diminish healthcare costs, it is difficult to quantify gains in waste, so they may go unnoticed”. Contrary to the majority’s opinion, two participants (#1 and #8) did not consider DAAS to have an impact on waste reduction. One participant (#6) did not provide a definite answer, explaining that they did not have the time to analyze the available data.

3.6. State Contribution

State contribution refers to all forms of money given, loaned, advanced, or reimbursed to the patients or the pharmacies in order to cover the cost of the service, and make it affordable. Regarding participants’ opinions about the State’s contribution to DAAS and the reasons behind it, all participants believe the State should contribute financially to some degree, so that patients, especially those with a handicap on therapeutic adherence or taking multiple drugs, can have access to this type of service. Participant #12 mentioned “It makes total sense, especially in those cases where there are adherence problems identified by doctors”. The reasons behind this opinion are based on the benefits DAAS has both for users (the impact assessment participants mentioned) and to the State. The State can save financial resources via the reduction of direct costs, as the service leads to the reduction of waste of reimbursed medicines, and indirect costs, because DAAS induces fewer complications of non-compliance to therapy and medication errors. Participant #6 summed this up in a very explanatory way: “The State contribution makes total sense, since the improvement on therapeutic adherence leads to better pathology control and decreases emergency visits and hospitalizations”. Furthermore, DAAS can promote an environmentally responsible disposal of waste: “It is important to note that by putting all empty packages into Valormed containers (an entity which manages medicines waste) we are also contributing to environmental sustainability, as we will be also reducing the health problems related to soil and water pollution by the chemicals from those medications” (#6). As stated by participant #17: “There are many people with medication managing difficulties who would benefit from this service and are unable to adhere for economic reasons. From a public health point of view, it would have a positive impact on the global improvement of the population’s health and quality of life due to increased adherence and monitoring of the therapy. In the long run it would translate into savings, as awareness about the correct taking of medication would avoid the reimbursement of thousands of boxes of medications that are left aside due to non-adherence”.

One participant (#2) also mentioned that with the State contribution, it would be possible to “stimulate the service provision”, including on institutionalized facilities that “sometimes cannot support that additional cost”. Furthermore, to make it work, participants said that “there is a need of more scientific data on DAAS’ advantages so that the State can see its true potential” (#2), “it should not be put at a maximum retail price as it happens on medicines because it excessively limits the market” (#4), and finally, “there needs to be a strong link between medical doctors and pharmacists” (participants #7, #10, and #14). In this topic, some ideas were suggested to increase the cooperation between pharmacists and attending physicians: “giving the pharmacists access to the full prescribed medication record of each patient and conversely giving doctors the possibility to navigate through the pharmacy records on therapeutic adherence, for example” (#2); “a practical system to notify the attending physician on side effects, interactions, and chronic therapeutic renewal alerts” (#1).

Participants #2 and #3 mentioned the need for quality assurance of DAAS: “Create uniform guidelines for quality assurance” (#2); “There must be a set of prerequisites concerning the provision of DAAS and the required competencies of the institutions that provide it” (#3). Participant #11 added: “Nowadays, local stakeholders’ contribution is being considered… given the lack of financial resources available it is difficult to have a centralized system. It is easier for city halls to implement such a system, but this might lead to inequalities between people living in different towns and cities in the same country”.

4. Discussion

This study aimed to characterize DAAS implementation in Portugal and understand the perceptions of technical directors, pharmacists, and/or owners of community pharmacies regarding the impact of DAAS, preferred methodology types, and State contribution.

DAAS is a recently provided service, which has been available on average for 4.8 years. It is important to stress that Portuguese legislation on DAAS was only passed in 2018 [ 35 ]. Following this publication, the Community Pharmacy College of the Ordem dos Farmacêuticos issued norms for service provision [ 36 ].The service is available for institutionalized and ambulatory users alike, with numbers served per pharmacy being highly variable.

In terms of DAAS characterization, a weekly manual blister pack is the most frequent methodology provided. The calculated user’s average cost per month was EUR 12.91, way above the literature reported cost the users are willing to pay for such a service (EUR 5 per month) [ 37 ]. This fact can be one of the reasons patients do not use this service, despite its advantages. The pharmacy’s calculated average cost was EUR 8.74 per month, reflecting an estimated profit of EUR 4.17 per month per user. However, it is important to emphasize that this data analysis is too simplistic, as estimation of pharmacy costs was only possible for some of the pharmacies. A previous study estimated the provider’s cost at EUR 6.76 per month [ 37 ], which is similar to the value obtained through the interviews. Furthermore, in Portugal, manufacturers supply medicines in blister packs, rather than bottles or tubs. In order to dispense into the devices, transfer of medication from blister packs increases the fill-times, and as a consequence, service cost.

In terms of the preferred methodology for service provision, weekly and automated were the top choices. However, high investment costs and a low number of current users make automation unprofitable, and hence, seldom available. It is interesting to note that pharmacies with a higher number of users, above 65, start providing an automated method in addition to the manual one. A weekly methodology is preferred because follow-up by the pharmacist is tighter and more rigorous.

Considering the impact on safety, the participants were unanimous in stating that DAAS has a positive impact, especially by reducing medication errors (overdose, forgetfulness, incorrect medicine, or wrong time and mode of administration), despite lack of objective data. This result is similar to unpublished data available for Portugal and abroad, namely from a randomized controlled trial in the United States [ 38 ], and the systematic review performed by Sinnemaki et al. [ 21 ].

The impact on therapeutic adherence is believed to be positive, but once again the participants mention the lack of time to analyze available data.

Regarding the impact on waste, the majority of the participants considered that there was a reduction of waste because the stock control is made by the pharmacy and prevents accumulation and abuse of medicines. There is also the indirect costs’ effect, as controlled patients tend to recur less to healthcare services. The most recent Portuguese study on medication waste dates back to 2007 [ 39 ]. At that time, the global waste identified in pharmaceutical units was 21.7% of the prescribed amount. About half (9.7%) was due to inadequacy of the size of the packaging(s) to the treatment instituted, and the other half (10.2%) to the non-adherence of patients to therapy [ 39 ].

Several systematic reviews on DAAS and DAA admit the possibility of positive effects on these three categories, and even a positive impact in clinical outcomes, although the quality of the available studies remains poor [ 20 , 21 , 22 ]. The study by Watson et al. stressed that organization devices may help unintentional medication non-adherence and could improve health outcomes [ 20 ]. This benefit was, however, not reflected by all studies.

As well as the potential benefits, DAAS may also introduce risks. Foremost, it introduces an additional step in the dispensing process when the pharmacist transfers prescribed medications into the DAA. Moreover, it is important to note that not all medicine can be packed in DAA, such as liquid or semi-solid formulations, medicines that degrade through air or light contact, and emergency medication. Even for solid medication, there is a paucity of data on the stability of chronic medications in DAA [ 40 ].

4.1. Limitations

This study is not without limitations. Firstly, considering the estimated population size, the sample size is low. According to data obtained from the Ordem dos Farmacêuticos (National Association of Pharmacists), around 10% of all pharmacies in Portugal provide the service ( n = 366). Moreover, taking into account the results of a literature review study that provided a systematic analysis of qualitative health research from 2003 to 2017, it was considered that 20 interviews would be enough to reach saturation [ 41 ]. The current global pandemic was probably a factor that affected the high rate of non-response. Furthermore, study participants were sampled using the convenience sampling approach. Therefore, the study may not fully represent the wide range of participants’ perceptions.

Secondly, there is also a possibility of a positive bias concerning DAAS’ impact since all the participants worked in pharmacies where this service was available, and thus they may want to emphasize DAAS’ positive qualities and benefits.

Finally, our interview guide was not pilot-tested before the beginning of the study and participants did not have an opportunity to go through the transcripts to validate what was said during the interviews. Additionally, they did not have the opportunity to analyze the data to provide their feedback on the appropriateness of the codes in capturing their perceptions. Although the field notes were not sent to the participants, we did send the manuscript for checking before submission.

4.2. Implications for Research and Practice

The participants indicated multiple benefits for DAAS, related to both patients and the healthcare system.

Our findings suggest that it is important to further research DAAS’ impact on safety, adherence, and waste, as there is still a lack of reliable data and good-quality studies.

It is also crucial to explore the reasons behind the low rate of implementation of this service among community pharmacies and the reasons behind the lack of users’ adherence to this type of service.

Based on the participants’ experiences, the following aspects can be highlighted:

• DAAS can have a positive impact on safety, adherence, and waste, especially for patients with complicated medication schedules, on multiple drugs, or with some level of cognitive impairment;
• DAAS is useful both for ambulatory users and institutionalized users;
• There is a need to make the service affordable for users, while not too cumbersome for pharmacies.

Acknowledgments

We gratefully acknowledge the study participants and the pharmacists within the Associação Nacional de Farmácias who provided national data on DAAS.

Appendix A. Interview Guide

• For how long has the Dose Administration Aid Service (DAAS) been available?
• How many users currently use the DAAS in your pharmacy?
• What methodology(ies) are available?
• Which of the methodologies do you consider to be the best?
• What is the average cost per month for users?
• What is the average cost per user per month for the pharmacy?
• Do you think that it makes sense to have a State contribution?
• Is therapeutic reconciliation associated with DAAS?
• What impact does this system have on user safety, bearing in mind that it is possible to associate therapy reconciliation?
• What impact does DAAS have on reducing waste at this time?
• What impact do you feel DAAS has on therapy adherence?
• The legal framework in which this service is inserted follows an after-sales service. What do you think about making this pre-sale, that is, within a unitary distribution system?
• With this system, would it be possible to reduce medicine waste?
• Why did your establishment not participate in the experimental regime introduced by the government in 2010?

Appendix B. COREQ Checklist

Consolidated criteria for reporting qualitative research (COREQ) checklist.

Author Contributions

Conceptualization, A.V. and O.L.; methodology, A.V. and O.L.; formal analysis, A.V. and M.L.; investigation, A.V. and B.M.; data curation, A.V.; writing—original draft preparation, A.V., B.M., M.L. and O.L.; writing—review and editing, M.L. and O.L.; supervision, O.L. All authors have read and agreed to the published version of the manuscript.

This research received no external funding.

Institutional Review Board Statement

The study was conducted according to the guidelines of the Declaration of Helsinki and approved by the Ethics Commission of the University of Beira Interior (process no. CE-UBI-Pj-2021-004:ID530 and 9 February 2021).

Informed Consent Statement

Informed consent was obtained from all subjects involved in the study.

Data Availability Statement

Conflicts of interest.

The authors declare no conflict of interest.

Publisher’s Note: MDPI stays neutral with regard to jurisdictional claims in published maps and institutional affiliations.

COMMUNITY PHARMACY AND MANAGEMENT – PRACTICAL

Course Code: ER20-22P

75 Hours (3 Hours/week)

Scope: The course is designed to train the students and improve professional skills to provide various pharmaceuticalcare services in community pharmacy.

Course Objectives: This course will train the students in the following

1. Professional handling and filling prescriptions

2. Patient counselling on diseases and minor ailments

3. Patient counselling on prescription and / or non-prescription medicines

4. Preparation of counselling materials such as patient information leaflets

5. Performing basic health screening tests

Course Outcomes: Upon successful completion of this course, the students will be able to

1. Handle and fill prescriptions in a professional manner

2. Counsel patients on various diseases and minor ailments

3. Counsel patients on prescription and or non-prescription medicines

4. Design and prepare patient information leaflets

5. Perform basic health screening tests

Note: The following practicals shall be carried out in the model community pharmacy with appropriate simulated scenarios and materials. Students shall be trained through role plays wherever necessary. The activities of the students shall be assessed / evaluated using a structured objective assessment form.

Handling of prescriptions with professional standards, reviewing prescriptions, checking for legal compliance and completeness (minimum 5)

Identification of drug-drug interactions in the prescription and follow-up actions (minimum 2)

Preparation of dispensing labels and auxiliary labels for the prescribed medications (minimum 5)

Providing the following health screening services for monitoring patients / detecting new patients (one experiment for each activity)

Blood Pressure Recording, Capillary Blood Glucose Monitoring, Lung function assessment using Peak Flow Meter and incentive spirometer, recording capillary oxygen level using Pulse Oximeter, BMI measurement

Providing counselling to simulated patients for the following chronic diseases / disorders including education on the use of devices such as insulin pen, inhalers, spacers, nebulizers, etc. where appropriate (one experiment for each disease)

Type 2 Diabetes Mellitus, Primary Hypertension, Asthma, Hyperlipidaemia, Rheumatoid Arthritis

Providing counselling to simulated patients for the following minor ailments (any three)

Headache, GI disturbances (Nausea, Vomiting, Dyspepsia, diarrhea, constipation), Worm infestations, Pyrexia, Upper Respiratory Tract infections, Skin infections, Oral and dental disorders.

Appropriate handling of dummy dosage forms with correct administration techniques - oral liquids with measuring cup/cap/dropper, Eye Drops, Inhalers, Nasal drops, Insulin pen, nebulizers, different types of tablets, patches, enemas, suppositories

Use of Community Pharmacy Software and digital health tools

Assignments

The students shall be asked to submit written assignments on the following topics (One assignment per student per sessional period. i.e., a minimum of THREE assignments per student)

SOPs for various activities in Community Pharmacy (as discussed in Theory and Practical)

List out the various abbreviations, short forms used in prescriptions and their interpretation

Patient Information Leaflet for a given chronic disease / disorder

Patient Information Leaflet for prescription / non-prescription medicines

Preparation of window / shelf display materials for the model community pharmacy

Overview of Software available for retail pharmacy management including billing, inventory, etc.

Dosage / Medication Reminder Aids

Overview on the operations and marketing strategies of various online pharmacies

Overview on the common fixed dose combinations

Overview on the medications requiring special storage conditions

Role of Community Pharmacists in preventing Antimicrobial Resistance

Jan Aushadhi and other Generic Medicine initiatives in India

Global Overview of Online Pharmacies

Community Pharmacy Practice Standards: Global Vs. Indian Scenario

Overview of pharmacy associations in India

Field Visit:

The students shall be taken in groups to visit community pharmacies and medicine distributors to understand and witness the professional activities of the community pharmacists, and supply chain logistics. Individual reports from each student on their learning experience from the field visit shall be submitted.

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12 Solutions to Medication Reminders for the Elderly

Navigating the golden years often comes with a set of pills to juggle. Forgetting a dose? We've all been there.

But as memories get a tad trickier, the right medication reminder becomes a game-changer.

Dive in to discover solutions tailored just for you, ensuring every pill is taken right on time.

Solutions to Medication Reminders

This article explores diverse methods, both traditional and modern, ensuring our seniors never miss a vital dose.

1. Written Logs and Calendars

Going back to basics, maintaining a handwritten log or marking medication times on a physical calendar can be highly effective.

It's tangible, always in sight, and there's something about pen-to-paper that reinforces memory.

2. Pill Organizers

These handy compartments, designed for daily or even weekly doses, simplify medication routines.

Arrange your pills at the start of the week, and each day, just pop open the relevant compartment.

3. Timer Clocks

A timeless solution! Simple timer clocks can be set to sound an alarm at your medication times.

Place one beside your medication stash, and it'll act as a regular, audible reminder. No frills, just efficacy.

4. Post-it Notes

Stick brightly colored Post-it Notes in locations you frequent, such as the bathroom mirror or fridge door.

Every glimpse reinforces the message, ensuring you don't overlook your meds.

5. Family or Caregiver Reminders

Never underestimate the power of a gentle nudge from someone who cares.

Whether it's a family member, friend, or caregiver, having someone to remind you can be both comforting and practical.

6. Apps and Software

With the rise of smartphones and tablets, numerous apps have been developed specifically for medication reminders.

They can be customized to your routine, sending notifications or alarms when it's time to take a dose.

7. Voice Assistants

Devices like Amazon's Alexa, Google Home, or Apple's Siri can be programmed to remind you about medications.

Simply set up a recurring reminder, and your voice assistant will notify you audibly.

8. Wearable Tech

Smartwatches and fitness bands often come with reminder features. Input your medication schedule, and the wearable will vibrate or beep, signaling it's time for a pill.

9. Subscription Services

There are services available that, for a monthly fee, will package and mail your medications in daily doses. Each day's packet is labeled, simplifying the process and ensuring you take the correct medications.

10. Smart Pill Containers

These containers are equipped with technology that can alert you when it's time to take your medication. Some even connect to apps on your smartphone, sending reminders and tracking adherence.

11. Alarm Clocks with Pill Compartments

An innovative twist on traditional alarm clocks, these devices come with built-in compartments for daily medications. When the alarm goes off, it's not just a cue to wake up but also a reminder to start the day with your necessary meds.

12. Integration with Smart Home Systems

Modern homes equipped with smart systems can be programmed to give visual or audible reminders for medications. Imagine your living room lights flashing or your TV pausing to remind you.

In today's world, there's a medication reminder for everyone's style and preference. From handwritten notes to tech-driven alerts, it's all about staying on track. Embrace the options available, and ensure every dose is timely for a healthier future.

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Never Miss a Dose Again: Powerful Medication Reminder App at Your Fingertips

Connected to over 95% of australian pharmacies.

Say goodbye to forgetting your medication with our intuitive medication management app.

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Why You Need a Medication Reminder App

Explore the features loved and relied on by more than 3 million Australians.

Improved Medication Adherence

Reminder alerts improve medication adherence, reducing missed or incorrect doses and enhancing overall health outcomes.

Avoidance of Medication Errors

Timely reminders minimize medication errors, preventing double doses, skipped doses, and wrong timing.

Enhanced Convenience

Get reminders on your smartphone or other devices to take your medications, even when you're busy or on the go.

Peace of Mind

Dosage reminders bring peace of mind by ensuring accurate adherence to prescribed treatment plans, alleviating anxiety and stress from managing multiple medications or complex dosing schedules.

Streamlined Prescription Management

Get dosage reminders and order repeat prescriptions with MedAdvisor to easily manage your medication.

Set reminders for loved ones to never miss medication doses, promoting adherence and overall well-being for both caregivers and those under their care.

How to make the most of your dosage reminders?

Set medication reminders easily by adding a new alarm in the 'Daily alarms' section of the MedAdvisor app.

Name the alert, schedule a time, and link it to your medication.

The reminder will come as a push notification at the set time.

If you have any further questions, please contact us on Support. We're always happy to help. Our support team is available Monday to Friday, 9AM–5PM (AEST).

Having the MedAdvisor app on my phone has just taken away any angst and concern that I had beforehand. It does all the thinking for me.”  Brooke, Stroke Survivor and MedAdvisor User

Trusted by over 3 million people worldwide

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Apple Store Reviews

Google Play Reviews

"This app is a must-have for those that take regular medication. The tap-to-order function is a godsend!! And the reminders are great when a dosage has changed. 5 stars." - Ruth S, Android App User

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"This app has helps me to manage my medications. I was forever forgetting to take medicines and running out and getting stuck. This never happens any more. I'm very grateful. Thank you" - Saskatoon James, Apple App User

See for Yourself

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Medication Management FAQs

A medication management app is a mobile application designed to help individuals manage their medications and improve medication adherence. These apps often include features such as medication reminders, refill alerts, and dosage tracking, as well as the ability to store information about medications, such as dosage, frequency, and side effects.

MedAdvisor is a medication management app that offers these features and more, allowing users to keep track of their medications and receive reminders and alerts to ensure that they take their medications as prescribed. The app also offers a range of other services, including medication delivery, prescription ordering, and medication review services. By using MedAdvisor, individuals can better manage their medications, improve medication adherence, and stay on top of their health.

No, a medication management app cannot replace a doctor's advice or prescription. While medication management apps can be helpful tools to assist with managing medications and improving adherence, they are not a substitute for medical advice from a healthcare professional. A doctor's advice and prescription take into account a person's individual medical history, current health status, and any other medications they may be taking. This personalized approach is important in ensuring that medications are safe and effective for the individual.

Additionally, medication management apps do not have the ability to diagnose medical conditions or adjust medication regimens in the same way that a healthcare professional can. It is always important to consult with a doctor before making any changes to medication regimens or making decisions regarding healthcare. Medication management apps like MedAdvisor can be a helpful tool to supplement medical care, but they should never be used as a replacement for professional medical advice and treatment.

Medication management apps, like any mobile application that handles personal health information, should prioritize the safety and security of their users' data. Reputable medication management apps, such as MedAdvisor, take extensive measures to ensure the safety and security of user data. These measures can include using data encryption to protect sensitive information and complying with relevant data protection laws. It's important to note that users also have a role in ensuring the security of their data when using medication management apps. This includes taking precautions such as using strong passwords, keeping their app up-to-date, and being aware of the app's privacy settings and permissions. Overall, when used responsibly and with proper precautions, medication management apps can be a safe and secure way to manage medications and improve adherence.

For more information visit - https://www.mymedadvisor.com/data-and-privacy

The cost of using a medication management app can vary depending on the app and the services it offers. Some medication management apps are free to use, while others may require a one-time purchase or a subscription fee to access all of their features. For example, MedAdvisor is completely free to download and use. The app provides medication reminders, refill alerts, and basic medication information for free to its users. There are no hidden costs or subscription fees to access these features.

Users only have to pay for the medications they are ordering through the app, and the payment is made directly to the pharmacy. MedAdvisor partners with a variety of pharmacies to offer convenient medication delivery and prescription ordering services to its users. Overall, MedAdvisor is a free and accessible tool that can help individuals better manage their medications and improve adherence.

MedAdvisor International Pty Ltd

Level 2, 971 Burke Road Camberwell VIC 3124 Australia

Email us: [email protected]  

MedAdvisor is an affiliate member of the World Pharmacy Council.  

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US6152067A - Medication dosage reminder device - Google Patents

• USPTO PatentCenter
• USPTO Assignment
• Global Dossier

Classifications

• G — PHYSICS
• G09 — EDUCATION; CRYPTOGRAPHY; DISPLAY; ADVERTISING; SEALS
• G09F — DISPLAYING; ADVERTISING; SIGNS; LABELS OR NAME-PLATES; SEALS
• G09F11/00 — Indicating arrangements for variable information in which the complete information is permanently attached to a movable support which brings it to the display position
• G09F11/23 — Indicating arrangements for variable information in which the complete information is permanently attached to a movable support which brings it to the display position the advertising or display material forming part of rotating members, e.g. in the form of perforations, prints, or transparencies on a drum or disc
• A — HUMAN NECESSITIES
• A61 — MEDICAL OR VETERINARY SCIENCE; HYGIENE
• A61J — CONTAINERS SPECIALLY ADAPTED FOR MEDICAL OR PHARMACEUTICAL PURPOSES; DEVICES OR METHODS SPECIALLY ADAPTED FOR BRINGING PHARMACEUTICAL PRODUCTS INTO PARTICULAR PHYSICAL OR ADMINISTERING FORMS; DEVICES FOR ADMINISTERING FOOD OR MEDICINES ORALLY; BABY COMFORTERS; DEVICES FOR RECEIVING SPITTLE
• A61J7/00 — Devices for administering medicines orally, e.g. spoons; Pill counting devices; Arrangements for time indication or reminder for taking medicine
• A61J7/04 — Arrangements for time indication or reminder for taking medicine, e.g. programmed dispensers

Definitions

• the present invention relates to a device for reminding a patient to take his next dose of medication. More specifically, the invention provides a very simple clock-like visual representation of the time when the last dose was taken or the time when the next dose is due.
• Modern medicine has produced a number of powerful and beneficial medications, including drugs to combat cystic fibrosis, heart disease, cancer, and AIDS. However, it is usually important that these drugs be taken at prescribed intervals; the drugs can be ineffective or even dangerous if taken at the incorrect time.
• U.S. Pat. No. 3,921,568 granted to William Joseph Fish on Jul. 25, 1973 for a, "Self Adhering Medication Time Reminder,” describes a six part device mountable on a medication container. Some of these parts are made of plastic and some are made of metal. The rigid construction of the device permits it to engage only flat surfaces such as the top of a pill bottle lid, a location where it might be jarred or damaged when the patient removes the lid.
• U.S. Pat. No. 5,271,353 granted on Dec. 21, 1993 to Gerard Besthorne describes a clock-like device which is attached to the side of a medicine bottle by means of a V-notch cut in the back of the device and an elastic strap which encircles and engages the bottle.
• the device has eight parts and adds greatly to the overall size of the bottle, making it difficult or awkward to place the bottle in one's pocket or purse for use outside of the home.
• What is needed is a device which is so simple in form and so cheap to produce that it could be economically inserted into a medication container by a pharmaceutical company or dispensed as a courtesy by a pharmacist with a prescription.
• the device should be so inexpensive that a patient would not hesitate to throw it out with the empty container and the pharmacological leaflet when his medication is finished.
• this product would be made entirely out of sheet material, such as paper, cardboard or plastic, making production of the device more akin to publishing than to manufacturing.
• the present invention is directed to such a device.
• the invention is a medication dosage reminder device constructed in two pieces from sheet stock such as paper, cardboard or plastic.
• the first piece is a hub having an indicator pointer.
• the second piece is an annular dial having clock markings. When the dial circumscribes the hub, the indicator pointer and the clock markings form a reminder indicating either the time at which the last dose was taken or the time at which the next dose is due.
• the hub may be adhesively fixed to a medication container such that the dial is free to rotate about the hub.
• a device mountable on a surface, for indicating the time at which a task was last completed or is next due, comprising: a sheet member having a central aperture and adapted to abut the surface; a hub having a diameter greater than the diameter of the central aperture of said sheet member; means for fixing a portion of said hub to the surface through the central aperture of said sheet member such that said sheet member is retained against the surface but is free to rotate about said hub and said fixing means; and co-operating indicia on said hub and said sheet member for indicating a time.
• said hub further includes a first pair of opposing protrusions extending radially outwards from the periphery of said hub and adapted to oppose the surface and to constrain said sheet member against the surface.
• said hub further includes a second pair of opposing protrusions extending radially outwards from the periphery of said hub and adapted to oppose said first pair of opposing protrusions such that said sheet member is constrained between said first and second pairs of opposing protrusions.
• Said sheet member and said first pair of opposing protrusions may be flexible.
• a device for indicating one member of a set comprising: a sheet member defining a central aperture; a hub having: a central pivot having a diameter less than the diameter of the central aperture in said sheet member; a first pair of opposing protrusions extending radially outwards from the periphery of the pivot and having a span greater than the diameter of the central aperture in said sheet member; and a second pair of opposing protrusions extending radially outwards from the periphery of the pivot and having a span greater than the diameter of the central aperture in said sheet member, the second pair of opposing protrusions being deformable away from the plane of the pivot such that the first and second pairs of opposing protrusions define between them a discrete annular channel adapted to receive for rotation therewithin said sheet member such that the central aperture of the sheet member encircles the pivot; and co-operating indicia on the hub and the sheet member for indicating one member of the
• the co-operating indicia includes: an annular arrangement of set members on said sheet member and a pointer on the pivot of said hub adapted to point to any one of said set members.
• the co-operating indicia includes: an annular arrangement of set members on the pivot of said hub and a pointer on said sheet member adapted to point to any one of said set members.
• the device further includes means for affixing said hub to a surface such that said sheet member may rotate thereabout.
• the device further includes means for affixing said sheet member to a surface such that the pivot on said hub may rotate within the central aperture in said sheet member.
• FIG. 1 is a perspective view of a medication dosage reminder device embodying a first aspect of the invention, the device being mounted to a medication container which is not part of the invention.
• FIG. 2 is a front view of the device of FIG. 1;
• FIG. 3 is a front view of the hub of the device of FIG. 1;
• FIG. 4 is a rear view of the hub of the device of FIG. 1;
• FIG. 5 is a front view of the dial of the device of FIG. 1;
• FIG. 6 is an exploded rear perspective view of a medication dosage reminder device embodying a second aspect of the invention.
• FIG. 7 is an exploded perspective rear view of a medication dosage reminder device embodying a third aspect of the invention.
• the reminder device 100 is formed from two parts: an annular dial 102 and a cruciform hub 104.
• the dial 102 and the hub 104 are preferably formed from flexible sheetstock such as paper, cardboard, or plastic and may be punched, cut, or similarly formed; however, more rigid material or material otherwise formed would also work in many applications.
• the hub 104 has two longitudinal tabs 106a, 106b, and two lateral tabs 106c, 106d which define at their intersection a pivot 108 having a diameter 110.
• the rear surface 118 of the hub 104 retains a strip of adhesive 120 extending along the lateral tabs 106c, 106d. This adhesive strip 120 serves to attach the hub to a medicine container C, not part of the invention.
• a scale 124 representing time of day.
• the time scale 124 preferably includes indicia for clearly distinguishing A.M. from P.M. times.
• a central aperture 126 passing through the dial 102 and having a diameter 128 which is slightly larger than the diameter 110 of the hub 104.
• the dial 102 is rotateably mounted on the hub 104, sandwiched between the tabs 106. Specifically, the front surface 112 of the lateral tabs 106c, 106d abuts the dial 102 and the rear surface 118 of the longitudinal tabs 106a, 106b abuts the dial 102 such that the dial 102 is locked onto the hub 104 but remains free to rotate about the pivot 108.
• the dial 102 and the hub 104 are somewhat frictional such that they will not rotate one their own accord but only under the control of the patient or some other user.
• the patient places a reminder device 100 on each of his medication containers C by securing the rear surface 118 of the hub 104 to the container C with the adhesive strip 120, the lateral tabs 106c, 106d embracing the container C and conforming to its exterior surface to increase the available mounting surface area.
• the patient then deforms the longitudinal tabs 106a, 106b in order to slip both of them through the central aperture 126 in the dial 102.
• the patient locks the annular dial 102 onto the pivot 108.
• the patient has two options.
• the patient might use the device 100 to indicate the time for his next dose if, on taking the previous dose, he advanced dial 102 so the hub "NEXT DOSE" indicator 114, 116 and the time scale 124 indicate the correct time for the next dose.
• a second embodiment 200 of a medical dosage reminder device is illustrated.
• the new hub 204 is similar to the original hub 104 except that the new hub 204 has two longitudinal tabs 206a, 206b but no lateral tabs.
• the annular dial 202 is adapted to be rotateably held against the medication container C, sandwiched between the rear surface 218 of the two tabs 206a, 206b and the container itself with the adhesive strip 220 replacing the pivot 108 found in the first embodiment.
• this second embodiment 200 might be simpler to manufacture and set-up than the first embodiment 100 but that the first embodiment 100 might be more robust because that pivot 108 keeps the dial 102 from slicing into the adhesive strip 120 and the lateral tabs 106c, 106d provide a larger surface area for engaging the container C.
• a third embodiment 300 of a medical dosage reminder device is illustrated.
• the new hub 304 is similar to the original hub 104 except that the new hub 304 has no tabs but instead has a diameter 330 greater than the diameter 328 of the central aperture 326 in the dial 302.
• the annular dial 302 is adapted to be rotateably held against the medication container C, sandwiched between the rear surface 318 of the hub 304 and the container C itself with the adhesive strip 320 replacing the pivot 108 found in the first embodiment. It can be appreciated that this third embodiment has similar advantages and disadvantages as the second embodiment.
• the dosage reminder device 200, 300 would be installed by abutting the dial 202, 302 against a surface of the medication container C and then placing the hub 204, 304 over top of the dial 202, 302 such that the adhesive strip 220, 320 passes through the central aperture 226, 326 in the dial 202, 302 and engages the container C.
• This arrangement lends itself to mechanization such that the dosage reminder device 200, 300 could be attached during the medicine packaging or labelling process by a pharmaceutical company.
• the dosage reminder device 100, 200, 300 is preferably made of relatively flexible material. This characteristic and the relatively loose connection between the dial 102, 202, 302 and the hub 104, 204, 304 permits the dosage reminder device 100, 200, 300 to work even while wrapped around curved surfaces. Therefore, the dosage reminder device 100, 200, 300 might be placed on a medication bottle itself, instead of on the bottle cap, so that it is more visible and less subject to damage caused by manipulating a "childproof" push and twist cap.
• the specific shape of the hub and dial may be varied so long as one is fixable to the medication container and the other can rotated thereabout while being otherwise retained in place. It is therefore contemplated that a different number or configuration of tabs could be used and that a different shaped aperture could be used.
• time indicia could be placed on the hub while the indicator arrow could be placed on the dial.
• the time scale might be set in minutes, hours, days, weeks, or any larger or smaller interval. It is still further contemplated that the device might find use in non-medical applications where tasks are repeated at intervals and a simple and handy reminder device would be of assistance. It is even further contemplated that a different scale might be used to represent members of a set other than the quantity time, for example people, places, or things.
• the adhesive strip could include any affixing means including various chemical adhesives, magnets, and mechanical couplers and fasteners.
• Engineering & Computer Science ( AREA )
• Health & Medical Sciences ( AREA )
• Physics & Mathematics ( AREA )
• General Physics & Mathematics ( AREA )
• Theoretical Computer Science ( AREA )
• Medical Informatics ( AREA )
• Life Sciences & Earth Sciences ( AREA )
• Animal Behavior & Ethology ( AREA )
• General Health & Medical Sciences ( AREA )
• Public Health ( AREA )
• Veterinary Medicine ( AREA )
• Medical Preparation Storing Or Oral Administration Devices ( AREA )

Description

Claims ( 11 ), priority applications (3).

Applications Claiming Priority (2)

Publications (1)

ID=25679477

Family applications (1).

Country Status (3)

Cited By (37)

Families Citing this family (2)

Citations (14)

• 1997-07-08 CA CA002210084A patent/CA2210084C/en not_active Expired - Fee Related
• 1998-06-30 US US09/110,380 patent/US6152067A/en not_active Expired - Fee Related
• 1998-07-03 GB GB9814501A patent/GB2327138A/en not_active Withdrawn

Patent Citations (14)

Cited By (58)

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Advisory Committee; Blood Products Advisory Committee; Renewal

A Notice by the Food and Drug Administration on 08/08/2024

This document has been published in the Federal Register . Use the PDF linked in the document sidebar for the official electronic format.

• Document Details Published Content - Document Details Agencies Department of Health and Human Services Food and Drug Administration Agency/Docket Number Docket No. FDA-2024-N-0008 Document Citation 89 FR 64930 Document Number 2024-17518 Document Type Notice Pages 64930-64931 (2 pages) Publication Date 08/08/2024 Published Content - Document Details
• View printed version (PDF)
• Document Dates Published Content - Document Dates Dates Text Authority for the Blood Products Advisory Committee will expire on May 13, 2026, unless the Commissioner formally determines that renewal is in the public interest. Published Content - Document Dates

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Advisory Committee

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Department of Health and Human Services

Food and drug administration.

• [Docket No. FDA-2024-N-0008]

Food and Drug Administration, HHS.

Notice; renewal of Federal advisory committee.

The Food and Drug Administration (FDA) is announcing the renewal of the Blood Products Advisory Committee by the Commissioner of Food and Drugs (the Commissioner). The Commissioner has determined that it is in the public interest to renew the Blood Products Advisory Committee for an additional 2 years beyond the charter expiration date. The new charter will be in effect until the May 13, 2026, expiration date.

Authority for the Blood Products Advisory Committee will expire on May 13, 2026, unless the Commissioner formally determines that renewal is in the public interest.

Christina Vert, Division of Scientific Advisors and Consultants, Center for Biologics Evaluation and Research, Food and Drug Administration, 10903 New Hampshire Ave., Bldg. 71, Silver Spring, MD 20993-0002, 240-731-3544, [email protected] .

Pursuant to 41 CFR 102-3.65 and approval by the Department of Health and Human Services and by the General Services Administration, FDA is announcing the renewal of the Blood Products Advisory Committee (the Committee). The Committee is a discretionary Federal advisory committee established to provide advice to the Commissioner. The Committee advises the Commissioner or designee in discharging responsibilities as they relate to helping to ensure safe and effective drugs for human use and, as required, any other product for which FDA has regulatory responsibility.

The Committee reviews and evaluates available data concerning the safety, effectiveness, and appropriate use of blood, products derived from blood and serum or biotechnology which are intended for use in the diagnosis, prevention, or treatment of human diseases, and, as required, any other product for which FDA has regulatory responsibility. The Committee also advises the Commissioner of Food and Drugs of its findings regarding screening and testing (to determine eligibility) of donors and labeling of the products, on clinical and laboratory studies involving such products, on the affirmation or revocation of biological products licenses, and on the quality and relevance of FDA's research program, which provides the scientific support for regulating these agents.

The Committee will function at times as a medical device panel under the Federal Food, Drug, and Cosmetic Act Medical Device Amendments of 1976. As such, the Committee recommends classification of devices subject to its review into regulatory categories; recommends the assignment of a priority for the application of regulatory requirements for devices classified in the standards or premarket approval category; advises on formulation of product development protocols and reviews premarket approval applications for those devices to recommend changes in classification as appropriate; recommends exemption of certain devices from the application of portions of the Act; advises on the necessity to ban a device; and responds to requests from the Agency to review and make recommendations on specific issues or problems concerning the safety and effectiveness of devices.

The Committee shall consist of a core of 15 voting members including the Chair. Members and the Chair are selected by the Commissioner or designee from among authorities knowledgeable in the fields of clinical and administrative medicine, hematology, immunology, blood banking, surgery, internal medicine, biochemistry, engineering, biological and physical sciences, biotechnology, computer technology, statistics, epidemiology, sociology/ethics, and other related professions. Members will be invited to serve for overlapping terms of up to 4 years. Non-Federal members of this committee will serve either as Special Government Employees or non-voting representatives. Federal members will serve as Regular Government Employees or Ex-Officios. The core of voting members may include one technically qualified member, selected by the Commissioner or designee, who is identified with consumer interests and is recommended by either a consortium of consumer-oriented organizations or other interested persons. In addition to the voting members, the Committee may include one non-voting representative member who is identified with industry interests. There may also be an alternate industry representative.

The Commissioner or designee shall have the authority to select members of other scientific and technical FDA advisory committees (normally not to exceed 10 members) to serve temporarily as voting members and to designate consultants to serve temporarily as voting members when: (1) expertise is required that is not available among current voting standing members of the Committee (when additional voting members are added to the Committee to provide needed expertise, a quorum will be based on the combined total of regular and added members), or (2) to comprise a quorum when, because of unforeseen circumstances, a quorum is or will be lacking. Because of the size of the Committee and the variety in the types of issues that it will consider, FDA may, in connection with a particular committee meeting, specify a quorum that is less than most of the current voting members. The Agency's regulations ( 21 CFR 14.22(d) ) authorize a committee charter to specify quorum requirements.

If functioning as a medical device panel, an additional non-voting representative member of consumer interests and an additional non-voting representative member of industry interests will be included in addition to the voting members.

Further information regarding the most recent charter and other information can be found at https://www.fda.gov/​advisory-committees/​blood-vaccines-and-other-biologics/​blood-products-advisory-committee or by contacting the Designated Federal Officer (see FOR FURTHER INFORMATION CONTACT ). In light of the fact that no change has been made to the committee name or description of duties, no amendment will be made to 21 CFR 14.100 .

This notice is issued under the Federal Advisory Committee Act ( 5 U.S.C. 1001 et seq. ). For general information related to FDA advisory committees, please visit us at http://www.fda.gov/​AdvisoryCommittees/​default.htm .

Dated: August 2, 2024.

Lauren K. Roth,

Associate Commissioner for Policy.

[ FR Doc. 2024-17518 Filed 8-7-24; 8:45 am]

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