Are pill organisers doing more harm than good?

The humble pill organiser could be doing more harm than good, according to researchers.

Researchers from the University of East Anglia have developed a guidance system to help prescribers and pharmacists decide which patients should use a pill organiser.

The study shows that over the last decade double the amount of pill organisers are being prescribed in the UK, and pharmacists are not considering the potential implications of patients suddenly taking all their medicine.

“The fact that using a pill organiser could cause harm to patients sounds rather counter-intuitive. But our research showed that patients were more likely to become unwell when they switched from taking their medication straight from the packet to using a pill organiser. In some cases, older people can even end up being hospitalised,” said lead researcher Dr Debi Bhattacharya, from UEA’s School of Pharmacy.

“This is likely because when the patients had been taking their medication sporadically, they weren’t getting the expected health improvements. Their doctor may therefore have increased the dose of the medication to try to get the desired effect.

“When these patients were switched to a pill organiser and suddenly started taking all of their medication as prescribed, they experienced side effects of the medication.”

The researchers found that with regular medicine packets, if a particular pill doesn’t agree with a patient they can easily identify and miss this pill, but with organisers this is more difficult, and patients tend to skip all of their pills instead.

This led to the development of the ‘Medication Adherence Support Decision Aid’ (MASDA). This attempts to discern who will most benefit from pill organisers. The algorithm helps prescribers consider barriers which may lead patients to miss medications.

“Emotional barriers to taking medication as prescribed can include things like whether the patient is anxious or lacking confidence, lacking motivation or experiencing unwanted side effects. In all of these cases, using a pill organiser is likely to be inappropriate,” Dr Bhattacharya said.

“Better solutions are likely to be identifying social support to boost the patient’s confidence, providing information on medication benefits, agreeing goals or even stopping the medication.”

Other barriers may be a patient’s physical abilities to use an organiser, their manual dexterity, visual abilities and memory.

“When switching from usual packaging to a pill organiser, we recommend that patients speak to their GP or pharmacist to check that the doses of their medication are appropriate.

“People who are already using a pill organiser without any ill effects should not stop using it as they do seem to help some patients take their medication as prescribed. It’s the switching stage which appears to be the danger.”