Eye drops, inhalers and tablets: how do you organise them all at once?

When an older person uses eye drops, inhalers and tablets, the challenge is making sure nothing gets left out: we suggest one treatment sheet and some practical tips.

To organise eye drops, inhalers and tablets together, the most effective tool is a single treatment sheet divided by time of day, showing everything: the tablets, which can be prepared in a pill organiser or a dosage system, and the eye drops and inhalers, which stay outside that system and need their own reminder and technique.

This is common in older people with glaucoma, COPD or asthma alongside other long term conditions. The risk is that whatever is not in the organiser is forgotten or used incorrectly. Here is how to avoid that.

Why is it harder when there are eye drops, inhalers and tablets?

Because each form of medicine is stored and used differently. Tablets can be prepared by dose, but eye drops and inhalers cannot: the good practice guide from the Spanish General Council of Pharmacists lists drops and aerosols among the forms that cannot be packed into a dosage system.

The result is that medication ends up spread across several places: the blister pack or organiser, the bathroom, the bedside table, sometimes the fridge. Without a system that brings it all together, it is easy for a dose of eye drops or an inhalation to be missed, even if the tablets are taken perfectly.

How do you make a treatment sheet that includes everything?

Make a single sheet, in large print, divided by time of day, and write down at each time everything that is due, whether tablet, eye drop or inhaler, copying the doctor’s instructions exactly. The General Council dosage system guide specifically says the device label should show the prescribed medication that is not included in the blister pack.

This table is only an example of the format: each person must follow exactly the times and doses their doctor has given. Place the sheet where medication is taken and keep eye drops and inhalers next to the organiser, except those that must go in the fridge.

How long should you wait between one eye drop and another?

If more than one eye drop is used in the same eye, Moorfields Eye Hospital, part of the NHS, recommends leaving five minutes between them, because otherwise the second drop washes out the first and it stops working. If there is also an ointment, the drops go first and the ointment five minutes later.

• Wash your hands and do not let the tip of the bottle touch the eye or eyelashes.
• After the drop, closing the eye and pressing gently on the inner corner for 30 to 60 seconds helps it absorb.
• Once opened, eye drops usually expire after 28 days, though this varies by product: write the opening date on the bottle.
• Some eye drops are kept in the fridge; check the leaflet.

If you are unsure which ones need to be kept cold, read what to do with medicines kept in the fridge.

What should you bear in mind with inhalers?

With inhalers, technique matters as much as timing: an inhaler used incorrectly may not reach the lungs. That is why it is worth having the pharmacy or health centre check how the person uses it, especially if they have a tremor, little strength or poor sight.

• If the inhaler contains a corticosteroid, the Preevid summary (Murciasalud) notes that the product information recommends rinsing the mouth with water after each inhalation and spitting it out without swallowing.
• Write on the treatment sheet when it is due and how many puffs, exactly as the doctor has said.
• Check the dose counter, if it has one, so you can order the next one before it runs out.

To review the most common mistakes, see frequent inhaler errors in COPD.

A practical example: Mercedes, glaucoma, COPD and six tablets

Let us take the case of Mercedes, 80, who takes six medicines as tablets, uses two eye drops for glaucoma and an inhaler for COPD. Her son has noticed that she takes her tablets correctly but often forgets the evening eye drop.

1. Her son asks the health centre for the updated treatment sheet and reviews it with the pharmacy.
2. The pharmacy prepares the tablets in a dosage system and gives her a sheet by time of day with everything else.
3. They put the eye drops and the inhaler in a small box next to the blister pack, on the kitchen table.
4. On the sheet, next to the evening pocket, «eye drops» appears in large print.
5. At the pharmacy they check her inhaler technique and remind her to rinse her mouth.

Now, when Mercedes opens the evening pocket, she sees the eye drop reminder and has it within reach.

How can IMA Health help?

At IMA Health we coordinate with a specialised pharmacy so that tablets are prepared by day and time, delivered to the home and followed up personally, without losing sight of medication that stays outside the blister pack, such as eye drops and inhalers. See how our home medication service works.

Sources

• Spanish General Council of Pharmacists: good practice in community pharmacy, preparation and provision of personalised dosage systems (2018, in Spanish)
• Moorfields Eye Hospital (NHS): how to use your eye drops
• Murciasalud, Preevid: preventing oral thrush with inhaled corticosteroids (2024, in Spanish)

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