People on high medication who fail to take prescribed drugs at the right time and right dosage risk jeopardising their health and independence. They can end up being re-admitted to hospital or placed in residential care for their own safety. This has huge cost implications for the NHS and social services.
Research shows 3-4 per cent of UK hospital admissions are a result of avoidable medicine-related illness, and between 11 and 30 per cent of these result from patients not using their medicines properly (1). The costs of admissions resulting from patients not taking prescribed medicines is estimated to be between £36m and £197m in 2006-07.
Home care visits and telecare services, such as telephone prompts are some of the ways used to ensure medication is taken. Devices such as dosset boxes, calendar clocks, blister packs and talking labels are also common. But the West Midlands Telehealthcare Network found the most successful solution cited by customers and carers was the PivoTell automatic pill dispenser.
The device is programmed to dispense pills up to 28 times a day. At the pre-programmed times, the internal pill cassette rotates, the alarm sounds and the correct dosage comes into view through the opening in the lid. Once the alarm has sounded the pills are released by tilting the dispenser allowing them to fall into the hand or a suitable container.
For the first ten people in the Dudley and Staffordshire areas who finished the six month pilot period, the total cost of the service was £80 per device and £120 dispensing costs for six months totalling £200 per person- £2,000 in total. There was a measurable decrease in GP visits, ambulance call outs, in-patient stays due to medication errors, domiciliary care packages and respite care. The total financial impact was a decrease in service costs of £39,000. This represents a return on investment of £19.50 per £1 invested.
Mr and Mrs J.
Mrs J suffers from Asthma and Chronic Obstructive Pulmonary Disorder (COPD) and was struggling with her medication. Mrs J was also responsible for making sure that her husband Mr J was taking the correct amount of medication at the right time. Mr J had lots of health problems and was constantly getting his medication mixed up.
Due to health problems Mrs J was not able to go out unaided and when she was taken out she got very anxious in case she could not get back to Mr J in time to give him his medication. To help him regulate his medication Mrs J bought a weekly pill box from the pharmacist that she filled but this caused problems as Mr J was still taking the doses at the wrong times. A case manager for health could see the distress it was causing Mrs J and the detriment it was having on her health so she referred Mr & Mrs J to the pill dispenser pilot.
Important factors before equipment was installed
The pharmacist was contacted and the referral sen for them to fill plastic inserts with the relevant medication. The GP and case manager was made aware of the situation and it was firstly given to Mrs J for her to get used to before being rolled out to Mr J.
Important factors after equipment was installed
The case manager was still able to support both Mr & Mrs J but did not need to do as many visits. Both Mr & Mrs J’s health improved and Mrs. J is much more confident about medication. She is now able to go out without worrying about getting back.
www.westmidlandsiep.gov.uk
