Win-Win with Technology Enabled Medication Support (TEMS)

If you can align what people want, with positive outcomes for the health system, you can create a win-win. 98 - 99% Medication Compliance

The WHO actually reported in 2003 that 50% of people do not take the medication that they are prescribed Medication Adherence: WHO Cares? - PMC (nih.gov). For a medication to reach efficacy, generally there needs to be an 80% compliance level Medication Adherence: The Elephant in the Room (uspharmacist.com). Many people do want to take their medication, but due to cognitive decline just struggle to remember. The medical system would call this group “non intentionally non-compliant”. Historically the only solution has been to send support workers in to support them. The impact though can be disabling for the person being supported. A slight deficit is quickly turned into a full deficit.

Providing people with the means to continue to take their medication independently, helps sustain a sense of autonomy and independence. For the user, they get consistent and reliable medication support designed around their needs. Devices alarm when they want and not when support workers are available.

Presented with the choice between an assistive device to dispense the right medication at the right time or a Support Worker to open a Blister Pack, people will mostly choose the device.

We know this as over the last 8 years the vast majority of the 400+ people who have been presented with this choice in Christchurch NZ via Nurse Maude, have chosen the device. Whilst 370 have trialled and become independent with them. This has been achieved in partnership with over 50 community pharmacies, whose commitment in supporting their customers has been exceptional.

The challenges in setting up the "Carousel" service offering has largely been around “Change Management”, getting people to understand and appreciate what Technology Enabled Medication Support (TEMS) can offer. Getting them to see that all though the person might have a label of “Dementia”, this does not limit their ability to learn new things, if they see the benefit for them. The critical point is to identify people at the right stage with their dementia. They need to have insight into their condition. Knowing that they are struggling, but want to continue to self-manage with a little help.

The win for the health system comes from capturing the right people at the right time with the right device. When you get all these in place you can make significant savings. The key is to focus initially on the people, and their needs and present them with a solution. It is also to do it safely, so the person is supported to learn the device and monitored it to make sure it continues to work for them.

People's journey with dementia can be long and they can manage for many years with Technology Enabled Medication Support. Once the habit and association become engrained, they hear the device and just take their medication. For some, devices can support them for months, others though can be supported successfully for years (even as long as 6 years).

Savings can be evidenced in visits saved, compared with Support Worker visits. A service does not need many people with devices to generate significant savings. With just 50 people on a TEMS Service, an organisation can save 1000’s of visits per month.

Regarding compliance levels with TEMS, once people are in a good routine with a reliable device you would expect a compliance level of 98-99%.

TEMS has the ability to help people maximise their independence, reduce the need for scarce staffing resources and ensure almost complete medication compliance amongst a group of people who want to take their medication, but just struggle to remember without a little help.

With the emergence of IoT, we can now capture compliance in real-time, evidencing that those using TEMS are taking their medication at the right time. If they miss the reminders from their TEMS device we can follow up with a call to check all is ok.