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19th November 2018

Verbal medication reminders

 

The verbal reminder (often referred to as prompting) is a commonly used medication support intervention for Service Users who can self-manage taking their medicines but may occasionally forget to do so.  But how useful is it as a way of helping Service Users take their medicines regularly, what are the risks, and what records need to be made?

Use and risks

For residents in care homes, reminders can be provided however frequently the resident needs to take their medication, but for Service Users receiving domiciliary care , the daily number and times of care worker visits may not match the Service User’s medicine regimen resulting in incomplete coverage. If the care worker doesn’t observe the Service User taking their medication, they may ask the Service User if they have taken it, but a yes or a no answer isn’t meaningful if the Service User is forgetful without checks in place to monitor their adherence.

Reminders can be useful in reablement services where a Service User is being assessed on their ability to self-manage their medication safely to determine what support they will require on discharge from the service. Regular checks should be made, with the Service User’s consent, on the quantity of medicine remaining so it can be calculated how well they are managing.

When an assessment indicates that reminders would provide the required support for a Service User in any setting, consider the following:

  • Gain consent from the Service User to being reminded to take or to being asked whether they have remembered their medication and that they agree to it being checked at intervals
  • Agree the frequency of reminder
  • Agree the frequency of checking the remaining quantity
  • Agree what to do if the Service User indicates, or it has been observed, that the medication has not been taken
  • Agree the period over which the activity should be undertaken before routine review.

These checks will highlight if reminders are unnecessary or where the Service User is forgetting more frequently so that the level of support can be reassessed.

Record-keeping

The expectation is that a record is made of the details of all medicines prompted, on each occasion a reminder is provided, including whether the care worker observed the Service User taking the medicine or not.  NICE Guideline NG67: Managing medicines for adults receiving social care in the community specifies that support with medicines administration is recorded in the Medication Administration Record.  Although NICE Guideline SC1: Managing medicines in care homes does not provide this detail, recording on a MAR chart is the safest and most efficient way of recording reminders.

*All information is correct at the time of publishing

Topics: General

Cathy Cooke

Cathy began her career over 40 years ago as a community pharmacist before gaining broad experience working across a range of settings including extensive primary care experience as: community pharmacist; prescribing support pharmacist working with a range of GP practices; and Head of Medicines Management within a large UK Health and Social Care Provider. As a Vice Chairman of NICE (The National Institute for Health and Care Excellence) – the Managing Medicines for People Receiving Social Care in the Community Group - she helped to ensure people had access to services and was recently was awarded a Fellowship of the Royal Pharmaceutical Society (RPS), the body responsible for the leadership and support of the pharmacy profession within England, Scotland and Wales. Cathy is a member of several groups, including a member of the NHS England National health and Justice Pharmacy Advisory Group and a board member of the Faculty of Forensic and Legal Medicine (Royal College of Physicians) Cathy regularly contributes to the pharmacy profession’s legal bible, the Medicine Ethics and Practice as well several other pharmaceutical journals.

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