Medication and supplements do no one any good just sitting in a bottle, and yet research and experience tells us that it’s all too easy to simply forget to take our pills. Fortunately, there are some simple and inexpensive/free tools available to help anyone improve their medication and supplements adherence.
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Contents:
What is medication adherence, and why is it a big deal?
Medication adherence refers to whether or not a patient is consuming and handling medications as prescribed. In most cases, that means whether or not the patient is taking precisely the prescribed amount at the prescribed time. Poor medication adherence can result in poor health outcomes, ranging from simply not getting the desired benefit if medication is not consumed, to potentially life-threatening adverse reactions. Adverse effects can also arise if a larger than prescribed dosage is taken intentionally or unintentionally. Unintentional overdosing can easily occur when patients forget that they’ve already taken a dosage, subsequently taking their medication a second time, resulting in potentially dangerous double dosing.
“Poor adherence leads to poor outcomes” - New England Healthcare Institute
An important point that is often overlooked is that medication adherence also includes proper handling of medication; for example, keeping medication out of direct sunlight, or in refrigeration, as instructed by a healthcare professional or medication product information.
Adherence isn’t just important for prescription medication, the importance of adherence to a supplements plan is often underestimated. It’s not always simply a matter of marginally boosting one’s immunity, some people rely on supplements for anxiety, supplements for weight loss, supplements for energy, or even supplements for acne - acne may not seem like a big deal, until you’re the one with acne.
On a societal level, to put it in economic terms, the cost of non-adherence across the population can be huge. According to one study, the cost of medical non-adherence from chronic diseases alone was roughly estimated to be approximately $289 billion dollars in the US alone. To put that in perspective, that’s more than the 2018 state government annual budgets of Texas and Florida put together.
“Poor adherence also leads to increased medical costs” - New England Healthcare Institute
The cost is especially bad for chronic conditions like osteoporosis, gastrointestinal issues, mental health issues, and cardiovascular issues.
These cost estimates don’t even include the cost of supplement non-adherence, which may be too hard to quantify. But even as an underestimate, the importance of this issue is plain to see: for individuals with health issues and across society, medication adherence is a big deal.
Why is medication adherence challenging for individuals?
When it comes to tackling medication adherence, there is a big picture view (whole of healthcare system) vs a focussed individual view (the adherence challenge of individual patients). Here, we will focus on individuals.
There’s two parts to this: proper handling of medication, and proper consumption of medication. Handling issues will vary significantly based on the specific handling requirements and environmental circumstances; e.g. if some medication needs to be kept in a cool climate, then this will be a problem in a hot environment with unreliable electricity.
But what about improper consumption of medication? The root-cause of that can be simplistically summarised as: human nature.
Human nature vs. medication adherence
Some people just don’t care about taking their medication. They may not believe that the medication will help them achieve their healthcare goals. Or, they may not even be fully invested in their healthcare goals. It may even be the case that they don’t believe their healthcare goals are achievable. This is a difficult issue to wrestle with, and we will explore this in a future post.
But what about people who are fully sold on the importance of adhering to their dosage plan of medication and supplements, but somehow still don’t adhere? For these people, it basically boils down to forgetfulness and the unpredictable and hectic nature of everyday life.
“Factors that triggered forgetfulness appeared to be a disruption in daily routine, such as a change in routine on weekends or on vacation, or other behaviours, such as falling asleep or being late for work. - Nair et al.
If that sounds like you… we’re here to help!
Three common reasons for failing to adhere to medication dosage plans
There are many reasons why someone might fail to stick to their dosage plans, but here are three common reasons:
Three major medication adherence challenges
- 1. Not having your pills with you at a dosage time
Whether you're travelling, or simply out of your home/office running an errand or making an appointment, if you don't have your pills with you, you can't take them - it's as simple as that really.
- 2. Forgetting a dosage due to a disruption in routine
Even if you are home, and your pills are less than 10 feet away from you, there's any number of reasons why some distraction may occur causing you to forget your medication.
- 3. Accidental overdosing due to forgetting that you have already taken a dosage
The irony is that when taking a dosage becomes second nature, it isn't always easy to remember that you've taken something. "Wait, did I already take my hypertension medication? I don't remember taking it, so I guess I didn't... but what if I did?" - it's easy to get stressed out because of this. This is also a problem for medication like pain-relief that has a time window (e.g. take one pill every 4-6 hours). "Wait, did I take that at 2pm? Or was it 3pm? Can I take another now?". Overdosing can be very dangerous, so this is a serious concern with certain forms of medication.
Now that we have identified 3 specific challenges to successful medication adherence, let’s see what tools are available to help us tackle each of these challenges.
Hacking adherence
Governments, healthcare providers, and insurance companies can wrestle with the big picture questions around how medical adherence can be improved across the entire healthcare system, but what can we mere mortals do to take better care of ourselves? Luckily there are some simple tools available to anyone who wants to improve their adherence to their chosen plan of medication and supplements.
Pill organizers
A pill organizer is a simple device designed to contain pills, including tablets, softgels, gummies, etc. The idea is to make it easy for someone to organize their pills into dosage groups: e.g. one of each pill to take each day, or one set of pills to take in the morning and another set to take in the evening, etc. Organizing your pills in this way, rather than taking each pill from its bottle when you need them, can improve adherence by making it more convenient to consume your pills.
But the main benefit to using a pill organizer is that it solves the problem of not having your pills with you at a dosage time. This is because the best pill organizers emphasize portability - even those with high capacity to hold a week’s worth of pills will have detachable segments so you can fit a day’s worth in your pocket.
To some extent, a pill organizer also addresses the problem of accidental overdosing due to forgetting that you have already taken a dosage, with respect to regularly scheduled dosages. What we mean is, if you organize your day’s dosage into your pill organizer, then you will always know when you’ve taken your medication, because the pill would have been removed from the organizer. This strategy may not be so effective for take as needed kinds of medication like pain relief (for that, TimerCaps are more effective, as we will see later), but it works great for medications with regular dosage, and supplements.
You can pick up basic pill organizers from any pharmacy or supermarket, but if you shop online you can get some excellent designs that complement any lifestyle (there’s even a design for adventure sports junkies) and are inexpensive. If you’re serious about improving your medication adherence, a good pill organizer can make all the difference. Because a pill organizer is the best option to improve adherence on travel, we’ve done a roundup of the best pill organizers for travel that are available to order online, so that’s a good place to start looking for one that suits you.
Full roundup of best pill organizers for travel ≫If you’re in a hurry, we’ve picked the best two options from our roundup. We’ve picked one compact option, and one high-capacity option. You can’t really go wrong with either of these. You should get the compact option, unless you’re sure you need greater capacity.
Best compact pill organizer
Vera Bradley Iconic Travel Pill Case
This was the number one pick overall in our ultimate roundup of pill organizers.
The standout characteristic of this pill organizer is the polished exterior which is available in many different styles including some masculine styles, but the polish isn't just skin-deep. This is a high-quality pill organizer that will keep your pills safe and will be easy to take with you wherever you go.
However, compactness comes with a necessary compromise: those who have many pills, larger pills, or go on very long trips, may need to look for a less compact pill organizer.
Best high-capacity pill organizer
LeanTravel 7 Day Travel Pill Case & Passport Wallet
This was the number two pick overall and number one high-capacity pick in our ultimate roundup of pill organizers.
With space for a pen and even a passport, LeanTravel are clearly targeting ultimate roadwarriors with this sleek, high-quality pill organizer. But even those who don't virtually live in airport lounges will appreciate this well-made 7x3 high-capacity pill organizer with detachable compartments for additional convenience.
Those with more modest capacity needs may be better off with a smaller unit like the Vera Bradley listed above.
Medication and supplements reminders apps
Life can be chaotic, and even the hardest-earned routine can be cast away by disruption - whether it’s travel, or a visitor, or any number of possibilities. That’s why relying on simply remembering to take your medication and supplements is a valiant but typically doomed strategy. It’s also completely unnecessary.
We all carry around a glorified supercomputer in our pockets, why not put it to good use, by getting a medication and supplements reminder app to help you stick to your dosage plan? A medication/supplements reminder app is the perfect tool for anyone worried about forgetting a dosage due to a disruption in routine.
There are various apps available for Android and iPhone, and we have our very own app that’s free and designed for individuals with active lifestyles.
With features like barcode scanning, privacy-safe notifications, and even a travel planner feature, our goal is for Intrepid Pillbox to make it as easy as possible for you to stick to your medication and supplements dosage plan. Check our the app here, or check out all our previous posts about it here.
And did we mention it’s free? It’s free.
TimerCaps
Imagine if your medication bottle could talk, and when you pick it up it tells you how long it’s been since you last opened it and retrieved a pill. That would be one way to mitigate the risk of accidental overdosing due to forgetting that you have already taken your pill, or to avoid the risk of popping a second pain killer too soon.
Good news, you don’t have to imagine, that’s exactly what TimerCaps do (except for the talking part). This simple device is in fact a generic bottle for your pills, with a special cap that keeps track of how long it’s been since it was opened. The idea is that you pick up your prescription and put the pills in this special bottle.
So if you’re someone who is often frustrated by the difficulty of remembering if you’ve already taken your medication, or if you’re often frustrated by the difficulty of remembering how long it’s been since you’ve taken your medication, then this multicolor 4-pack of TimerCaps is a great way to start - different colors help you stay organised if you have different types of pills, and if you don’t need all 4 you can easily gift 1 or 2 of the bottles.
Conclusion: where should you start?
In this post, we have gone over what medication adherence is about and why medication adherence can be a challenge for individuals. We then went on to list three major medication adherence challenges that individuals may face. To recap, those challenges are:
- Not having your pills with you at a dosage time.
- Forgetting a dosage due to a disruption in routine.
- Accidental overdosing due to forgetting that you have already taken a dosage.
We also identified three tools that you can use to improve your adherence. To recap, those tools are:
Each tool addressed each challenge to varying degrees. For each person, the significance of each adherence challenge will vary. Therefore, we can recommend the best tool category for each person based on what challenge is most relevant to them.
If your biggest challenge is not having your pills with you at a dosage time, then you should look into getting a pill organizers. This is definitely the best place to start for anyone who tends to “fall off the adherence wagon” when they travel.
If your biggest challenge is forgetting dosages, whether this is due to disruptions in routine or you simply have an unpredictable lifestyle, then it would be well worth trying a reminders app. Intrepid Pillbox is free to use so there’s no downside to trying it out to see if it works for you.
If your biggest challenge is forgetting if you’ve already taken a dosage, or forgetting when you took a dosage, such that you are at risk of overdosing, then you should definitely consider if TimerCaps could work for you. A pill organizer could definitely help with this as well, if your challenge is primarily with regularly scheduled items (i.e. take once a day prescriptions rather than take as needed no more than once every 4 hours kinds of prescriptions as is commonly the case with pain relief, for example).
Whatever option you try first, the most important thing is to be patient with yourself. Adherence is hard. There’s a reason it costs the US healthcare system billions of dollars. But there’s certainly ways to get better at it, and the first step is to take advantage of all the inexpensive and free tools that are out there.
We hope this post can help you on your journey to better adherence. All the best, and as always, feel free to let us know how you go with any of these tools that we’ve highlighted above. You can reach us in the comments section below, or contact us directly - we’d love to hear from you!
References
Here at Intrepid Wellbeing we prefer to source information from high-quality, academically rigorous sources. These are the references we used to develop this article:
- New England Healthcare Institute. Thinking outside the pillbox: A system-wide approach to improving patient medication adherence for chronic disease. New England Healthcare Institute, 2009.
- Cutler RL, Fernandez-Llimos F, Frommer M, et al. Economic impact of medication non-adherence by disease groups: a systematic review. BMJ Open 2018;8:e016982. doi: 10.1136/bmjopen-2017-016982.
- Nair KV, Belletti DA, Doyle JJ, Allen RR, McQueen RB, Saseen JJ, Vande Griend J, Patel JV, McQueen A, Jan S. Understanding barriers to medication adherence in the hypertensive population by evaluating responses to a telephone survey. Patient Prefer Adherence. 2011 Apr 29;5:195-206. doi: 10.2147/PPA.S18481.