Consistency is a key part of ensuring that a prescribed medicine works effectively. It needs to be taken as directed every time according to the instructions on the label and the advice of your doctor or prescribing pharmacist.
However, it is no secret that this is not always the case, and sometimes prescription doses are missed or skipped for a wide variety of reasons, from difficulties accessing a prescription to side effects relating to certain medicines themselves, and particularly complex needs that require multiple medicines to be taken at different times.
There is an entire field of study and practice known as adherence that looks into ways to make it as easy as possible to access and take medicines as and when required, in order to boost physical health, mental wellbeing and independence.
Part of this approach is using the electronic prescription service to make medicine access easier, particularly for repeat prescriptions, as well as ensuring that a support structure is in place to offer advice, tips, tools and technologies that can help.
One particularly interesting development when it comes to the latter is the incorporation of smart technology such as intelligent cabinets, which could have the potential to transform the lives of people who have complex support needs.
The Smart Medicine Cupboard
One particularly interesting trial, described by NHS Grampian as a world first, is a medicines cabinet that allows patients and primary caregivers to administer their own medicine in a secure and safe environment.
The test of the technology at Royal Aberdeen Children’s Hospital aimed to help the support of a 13-year-old with particularly complex medical needs.
These include Chiari type II, or Arnold-Chiari Malformation, which is a complex condition where the brain pushes against the spinal cord, which can affect breathing and swallowing. He has spent his life in and out of the hospital due to the condition, with consequential effects on his routine.
His mother noted that the nature of a hospital ward means that it is not always easy to maintain the same routine with medication there as it would be at home, and discussed the problems with having to chase already busy nurses during times when she knows medication is needed.
The intelligent cabinet gets around this by allowing for a self-administration routine, allowing her to access the medication herself using a security access wristband and see when dosages have been given and need to be given next.
It provides notifications and reminders for which medications are needed next and opens the appropriate drawer to do so.
The system is an adaptation of intelligent security cabinet technology that already exists, but the potential for it to be used in medicine has been unrealised as of yet.
The same types of technology used here have primarily been used in business contexts such as fleet management key lockers and hotel security cabinets, but the scheduling and access control technology was, according to NHS Grampian and the technology providers, applicable to medicine management.
Three of the machines have been trialled at Royal Aberdeen Children’s Hospital, and whilst there are still adjustments that need to be made following feedback from medical professionals, patients and caregivers alike.
The biggest limitation of the technology used in the trial was a lack of refrigeration, meaning that certain medications cannot be used with it, particularly if they degrade quickly at room temperature.
Self-administration is not always possible, nor is it always suitable, but it can be a beneficial approach to assist in adherence both inside and outside a hospital setting/
It can serve, in some cases, as a bridge to independence, where the reminders to take medication and the routine of opening the cabinet will translate to routines once discharged from the hospital.
In other cases, it could be used to make the routine of managing medicines at home significantly easier. One of the caregivers who tried the machine wanted to have one for her home in preparation for being discharged from the hospital after a stay of over a year.
As this trial is a world-first, it will take quite some time for conclusions to be drawn on how much it helps adherence, particularly in clinical settings, let alone become widely available for people to buy.
There are quite a lot of tools, apps and exercises that people can try to remind them to take medication, which ranges from simple alarms and scheduled pillboxes to more elaborate apps that provide alerts in various forms to ensure the right medicine is taken in the right amounts at the right time.
An intelligent cabinet is a large-scale version of this, and it remains to be seen if it has significant benefits for people with complex prescription needs.
Frequently Asked Questions
An intelligent cabinet is a secure, connected medication management system that stores and dispenses medicines at the correct time. It can send reminders, record doses taken, and share information with carers or healthcare professionals when required.
Yes. By providing scheduled reminders and controlling access to medication, intelligent cabinets can help reduce missed or incorrect doses. They may be particularly beneficial for people managing multiple medicines or long-term conditions.
Intelligent cabinets may benefit older adults, people living independently, those with complex medication regimens, and individuals who receive support from family members or carers. They can also provide reassurance by helping medicines be taken correctly.
Availability varies depending on the NHS service or local healthcare provider. Some areas are trialling intelligent medication cabinets as part of digital healthcare initiatives, while others may offer similar medication support services.