I take 6 medicines a day: how to stay on top of them on my own

A simple five-step system for handling several treatments yourself, without missed doses or doubts.

To manage six medicines a day without depending on anyone, you need a system that does not rely on memory alone: an up-to-date list, a few fixed dose times, a pill box or a personalised dosage system (SPD) and a way of tracking when each box runs out. Setting it up takes an afternoon; after that, keeping it going takes a few minutes a week.

Taking several medicines does not make you dependent. What gives you independence is being clear about what you take and when, and being able to check it yourself. Here is a step-by-step method.

It is not a question of willpower but of method. The World Health Organization points out that, in developed countries, average adherence to treatments for chronic conditions is only around 50%, and that problems arise whenever people have to take their treatment by themselves. The simpler your system, the fewer decisions you have to make each day.

Step 1: how do I make a medication list that actually works?

The list is the basis of everything. Include every medicine, also those you take without prescription, supplements and those you only use now and then.

Keep it in your wallet or on your phone and update it whenever something changes. Our guide on how to make your medication list has more detail.

Step 2: how do I group my doses so I do not forget them?

Ask your pharmacist to check with you whether your doses can be concentrated into three or four moments of the day, respecting the instructions for each medicine (some are taken on an empty stomach, others with food, others at night). Then link each moment to something you always do.

• Empty-stomach medicines: next to the glass of water when you get up.
• Breakfast medicines: beside the coffee maker or wherever you have breakfast.
• Dinner or bedtime medicines: next to your toothbrush or bedside table, if they do not need food.
• A phone alarm for doses that do not match a routine.

If technology helps you, read our selection of alarms and apps so you do not forget your medication.

Step 3: weekly pill box or SPD?

Both let you see at a glance whether you have taken each dose. The difference is who prepares it. You fill a pill box yourself every week; a personalised dosage system (SPD) is prepared by a pharmacist, who repackages your medicines into a blister by day and time after dispensing them.

According to the good practice guidance of Spain's General Council of Official Colleges of Pharmacists, the SPD aims to make medicine use safer, improve adherence and provide personalised information. Not everything can go in: syrups, sachets, drops, inhalers, patches, effervescent tablets or medicines that need refrigeration, for example, are left out.

If you choose a pill box, here is how to set up a weekly pill box.

Step 4: how do I avoid running out and how often should I review my treatment?

With six boxes, each one runs out on a different day. With Spanish electronic prescriptions, the next supplies of a long-term treatment can be collected from a few days before the previous one ends (ten calendar days under national rules, although your region may set a different period).

• Note in your calendar the approximate date each medicine runs out and set a reminder a week before.
• Try to collect everything in a single trip to the pharmacy.
• Check your region's health app for active prescriptions and when each treatment expires.

Finally, ask for a review of all your medication whenever something changes (a new medicine, a hospital stay, a new specialist) and, in any case, regularly with your doctor or pharmacist. Take your list and ask whether everything is still needed and whether your schedule can be simplified.

A practical example: Ramón, 69, and his Sunday method

Take the case of Ramón, 69, a widower who lives alone and takes six medicines for blood pressure, cholesterol, his prostate and his stomach. His children live in another city and he wants to keep managing on his own.

Ramón writes his list with his pharmacist's help, and she confirms that he can group his doses into two moments: breakfast and dinner. Every Sunday after lunch he fills his weekly pill box with the list in front of him and checks his calendar to see whether any box runs out that week. He keeps the pill box next to the coffee maker.

After a few months, he decides to try an SPD prepared at the pharmacy to save his Sunday session and the worry of having made a mistake filling it. He still manages his own medication, but with less work.

How can IMA Health help you keep your independence?

If you would rather not spend time every week preparing tablets or keeping an eye on prescriptions, at IMA Health we coordinate with a specialised pharmacy that prepares your medication by day and time of each dose, we deliver it to your home and we provide personalised follow-up. You decide and take your medication; we take care of the logistics. Find out more about our home medication service.

Sources

• WHO: Failure to take prescribed medicine for chronic diseases is a massive, world-wide problem
• General Council of Official Colleges of Pharmacists: Good Practice in Community Pharmacy no. 14, SPD service (PDF, in Spanish)
• BOE: Royal Decree 1718/2010 on medical prescriptions (in Spanish)

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