How to link each medication dose to a daily habit

Linking each dose to something you already do every day is one of the simplest ways to remember your medication without relying on anyone.

The simplest way not to forget a dose is to link it to something you already do every day without thinking: switching off the alarm, making coffee, sitting down to dinner or brushing your teeth. The habit then acts as the reminder and you no longer depend only on your memory or on anyone else.

In this article we explain why it works, how to choose the right habit for each medicine and what to do when your routine changes.

Why does linking a dose to a habit work?

Because the habit you already have acts as an automatic reminder: you no longer rely on remembering, but on something you are going to do anyway, such as having breakfast or brushing your teeth. The Spanish Society of Hospital Pharmacy (SEFH) recommends taking your medication at the same time each day, linked to a regular daily activity, for example a meal, coming home or going to bed.

Behavioural psychology calls this a cue or trigger. A University College London study (Lally and colleagues, 2010) followed people repeating a new daily behaviour linked to a daily cue: on average it took them 66 days for it to become almost automatic, although the range was very wide (from 18 to 254 days depending on the person). The good news from the same study: missing a single day barely affected the process.

Which habit should you choose for each dose?

Choose something you do every day, at a similar time and in the same place, and that fits what the leaflet says for each medicine (on an empty stomach, with food or at bedtime). The most reliable cue is the one you never skip, not even at the weekend.

How do you build the routine step by step?

1. Make a list of all your medicines with their times and whether they go on an empty stomach, with food or at bedtime. If you are unsure, ask your pharmacist to go through it with you.
2. For each dose, write a sentence like "When I do X, I will take Y". For example: "When I brush my teeth at night, I will take my cholesterol tablet".
3. Keep the medication where the habit happens, as long as the place is safe: out of children's reach and away from the heat and damp of the bathroom or the hob.
4. Use a pill organiser or a system that shows you whether you have already taken the dose. The SEFH recommends it precisely as a visual reminder.
5. Add a back-up alarm for the first few weeks and remove it once you no longer need it.
6. After a month, check which doses you still forget and change the cue for those.

If you want to combine habits with technology, our article on alarms and apps so you do not forget your medication has practical options.

What should you do when your routine changes?

When the habit disappears (holidays, a change of shift, a trip), the cue disappears too, and that is when most missed doses happen. Prepare a replacement cue before your routine changes: an alarm, a note in your wash bag or carrying the day's doses in a pocket pill box.

• Weekends: if you get up later, keep the same cue (for example, the first glass of water) even if the time changes, unless your doctor has told you to follow a strict schedule.
• Trips: keep your medication in your hand luggage and link the dose to something you repeat anywhere, such as brushing your teeth.
• If you miss a dose: do not take a double dose. Follow the leaflet for that medicine or ask your pharmacist; there are more details in what to do if you miss a dose.

A practical example: Marta and her three doses

Let us take the case of Marta, 58, an office administrator with high blood pressure, high cholesterol and an underactive thyroid. She takes levothyroxine on an empty stomach, a blood pressure tablet in the morning and a statin at night. Until now she took them "whenever she remembered" and some weeks she missed two or three doses.

With her pharmacist's help, Marta reorganises her doses like this: the levothyroxine on her bedside table, next to a glass of water, to take when she switches off the alarm (the Eutirox leaflet says to take it on an empty stomach, at least half an hour before breakfast); the blood pressure tablet next to her breakfast cup, in a weekly pill organiser; and the statin next to her toothbrush, in a closed box. For the first two weeks she keeps an alarm at 22:30. After a month, she only remembers missing one night, when she slept away from home, so she adds a spare dose to her wash bag.

How can IMA Health help?

Linking doses to habits works best when each dose is ready and visible. With IMA Health, a specialised pharmacy prepares your medication by day and time of each dose, so all you have to do is link each compartment to its habit. IMA takes care of coordination with the pharmacy, home delivery and personalised follow-up, so you keep your independence with greater peace of mind.

Sources

• Spanish Society of Hospital Pharmacy (SEFH): Tips to help you take your medicines (2018, in Spanish)
• British Psychological Society, Research Digest: How long to form a habit? (on Lally and colleagues, 2010)
• CIMA, AEMPS: Eutirox (levothyroxine sodium) package leaflet (in Spanish)

This article is for information only and does not replace advice from your doctor or pharmacist.