This project was initiated by the Adult Social Services in the West Midlands (UK) seeing that the consequences of poor medication adherence have led to an increment of health care cost (Average of £9 billion spent on medicines, 927 million prescriptions, and more than £100 million in unused drugs are returned and destroyed). Non adherence to their medication has also led to another problem where the patients could be admitted to the hospital. The cost of hospital admission in UK was estimated to be between £36m and £197m in 2006-7.
The aim of this project was to test the effectiveness of the automated pill dispenser in supporting people towards better self-management of medication.
[As compared to UK, there was no or little validated medication adherence scale or study done to the patients in Singapore. The cost inflicted due to non adherence to medication was not found in any research neither.]
Key points from this report:
In this 6-month project, 380 people were involved (135 of them over 85 years old and 144 aged between 75 and 84). Apart from old age, some of them have medical conditions such as dementia (forget to take medicine or forget having done so), physical disability ( dexterity issues), and sensory disabilities (lack of visual capacity). As the pill dispenser acts as a reminder, it is not suitable to those with a history of deliberate non-adherence.
1. The pill dispensers are filled by pharmacists in order to reduce the possibility of dispensing errors.
2. The pill dispenser used was PivoTell. Tipper can be used together with it in order to help those with physical or sensory disabilities. Watch demo here.
3. The safety and suitability of medication have to be considered as well. Some pharmacists raised the issues of efficacy of medications when the tablets had to be removed from their original air tight packaging to be placed in the pill dispenser. Some tablets need to be refrigerated while some disintegrate when removed from air tight packaging. The size and amount of the tablets can be an issue as well. Of course, soluble medicines, cream, liquids, eye drops and other external products cannot be used with the pill dispenser. But the alarm can be set as reminder for those medications.
4. ROI was measured by the cost savings across the Health and Adult Social Care economies and the improved quality of life for people who use services and their carers.
5. The overall cost benefit was positive with the following outcomes:
– reduced hospital admission
– reduced medication prompt visits
– share of savings (48% social care vs 52% health)
– ROI (£8.50 per £1 spent)
– reduced untaken medicine
– cost avoidance savings
6. Case studies showed that the pill dispenser has had a positive impact on the lives of the people that used the dispensers and their carers.
7. Promote a bespoke or personalised approach towards medication management
8. The project aim was evidenced by
– improved quality of life for people and their carers
– increased capacity to remain independent at home
– reduced reliance on health and social care services (thus reduce cost)
9. This project was more successful within social care sector.
Learning from this report:
- Make visit to hospitals/elderly home or do survey to better understand the local needs (SG Social Service) – who to contact? how to get started??
- Do a pilot test after the prototype is out – safety issues
I am actually stuck at this point of time. 😦 Where and how should I get started?? I can’t find statistics. Exams are near, interim report deadline is nearer. 😦