Patients, families find it easier
A new type of medication service is beginning to capture the interest of hospices and families of hospice patients. The system, called Medicine-On-Time, provides patients with medication that is divided into doses corresponding to a calendar-formatted card.
Hospices who have used the Medicine-On-Time distribution method find that it eliminates emergency room visits because there are no lapses in medications. The system also reduces some of the time a hospice nurse might have otherwise spent in assisting patients and families with complex medication regimens, says Stacy Fortier, CPE, director of pharmacy education at The Medicine Shoppe of New Bedford, MA. "It’s a much more effective way to give medications," Fortier says.
For example, if a hospice physician wants to prescribe a patient a medication that will be used only on an as-needed basis, the Medicine-On-Time distribution method makes it easy for the hospice to provide the patient with a special packet that will be taken only if needed in the dosage amount already enclosed in the packet, Fortier explains.
So if the patient needs that particular medication, the patient’s family won’t have to make a special trip to the pharmacy to fill it, she adds.
Also, if there’s a snowstorm or other weather that prevents a hospice nurse from visiting the patient or explaining any change in a patient’s medication, the Medicine-On-Time system will enable the family to call for a refill that will be delivered in whatever dosages the hospice physician most recently had prescribed. The patient will simply take what is included in the calendar packet for that date and time, Fortier says. "We also provide prescription relief kits that are kept on hand at all times," she says.
The Medicine-On-Time service originally was designed for independent, ambulatory patients who wanted to stay out of a nursing home but who needed some help in remembering their medications, says Ian Salditch, chief executive officer of Medicine-On-Time in Owings Mills, MD. "This is a common experience that people have of going over to an elderly patient’s house and setting up the person’s medications for the next week because the person is not able to manage the variety of medications and conflicting dose schedules themselves," Salditch says.
So the system was designed to be easy enough for the average person to self-administer, Salditch notes. "While that is still what we essentially would term our primary market, other secondary markets, which in the past had been considered a part of the long-term care infrastructure, introduced themselves to us," Salditch says. "We found there were many settings where lay people were responsible for distributing prescription medications."
The company’s primary mission is to simplify drug administration. It has found a wide audience, with about 400 pharmacies in 43 states using the system, Salditch says.
The Medicine Shoppe, which is one of those pharmacies, found that the distribution system may meet resistance at first, but once it’s been tried, it’s a quick sell, Fortier says. "When we started with one hospice, they said, We won’t need the prescription system because the family takes care of it,’" she says. "Then when hospices realized the system alleviated pill problems with patients, I’ve found that more hospices are adopting the system because it’s much more cost-effective this way — and it’s safer."
The Medicine Shoppe will deliver the medication calendar packets on a monthly, weekly, or biweekly basis, depending on the patient’s needs and the hospice’s directions, Fortier says. Also, if patients are transferred or travel outside of the delivery service area, the packets, which come in a hard plastic shell, can be mailed, she says.
For patients who have difficulty seeing or reading, the medication packets are color-coded so that one color always means to take the enclosed pills at a certain time of day, Fortier says. "It’s delivered days before the rotation of new medication starts, and it’s personalized for each particular patient as he or she needs it," Fortier adds.