Automatic pill dispenser guide: alarms, locks and who fills it

Who an automatic pill dispenser helps

Say your mother takes four medicines at three different times, and lately you find Tuesday's pills still in the box on Thursday. A plain weekly box shows what she missed, but it cannot remind her or stop her taking the next dose early. That gap is what an automatic dispenser is built for.

MedlinePlus describes automatic dispensers as holding 7 to 28 days of pills, with a blinking light and an audio alarm as reminders. Most have a locked lid, so only the person with the key can reach the stored doses. Only the compartment that is due opens.

• Someone who forgets doses, or is not sure whether a dose was taken
• Someone who might take extra pills from the next compartment
• A family helper who lives nearby and can fill the tray every week or two
• A home where a key-locked store keeps pills away from visitors or grandchildren

Start with the pharmacist: which medicines can go in

Some tablets keep well in their blister pack but not loose in a tray. The NHS Specialist Pharmacy Service says the preferred option is to keep medicines in their original packaging, and that deciding whether a medicine goes into a compartment aid is a matter of professional judgement. It also advises keeping such trays out of bathrooms and kitchens, and away from direct light.

So bring the full medicine list and the bottles to the pharmacy, as MedlinePlus suggests, and ask plainly: "Which of these can sit loose in a dispenser for up to four weeks, and which must stay in the pack?" Some pharmacies also offer to fill trays, so it is worth asking.

• Ask: "Can this tablet be stored out of its blister for 28 days?"
• Ask: "Do any of these need to be taken with food or at an exact time?"
• Ask: "Is there anything here I should never take together?"
• Keep liquids, inhalers and fridge medicines outside the dispenser

What to check in a pill dispenser with alarm

Count the doses first. Multiply the doses per day by the days you want between refills, and check that the tray has enough compartments. A 28-compartment tray lasts 28 days at one dose a day, but only seven days at four doses a day.

Then picture the person using it. Can they hear the alarm from the next room, see the light, and tip the tray with a weak or shaky hand? A good question for the seller is: "What happens to the alarm and the lock if the batteries run flat?"

• Doses per day times days between refills, against the compartment count
• How many tablets fit in one compartment, including large ones
• Alarm volume and length, and whether a light flashes as well
• A key-locked lid, and a spare key kept by a second helper
• Battery type and a low-battery warning

Locked dispenser, alarm pillbox or weekly organizer

There are three common routes. A weekly organizer is a row of lidded boxes with no reminder. An alarm pillbox adds a beep but leaves every day open. A locked automatic dispenser reminds, opens only the dose that is due, and keeps the rest behind a key.

Our product pick is a locked dispenser, and the facts below come from the maker's page for the white-lid model. Locked units like this sit at the high end of the price range, so a simpler route may be enough for many homes.

Put simply, a weekly organizer suits someone who only needs a tidy layout. An alarm pillbox suits someone who forgets the time but takes the right pills. A locked dispenser suits someone who might take a dose twice, or take tomorrow's pills today.

• e-pill MedTime Station Pro: two 28-compartment trays that share one locking lid, item 993040
• Capacity: up to 18 large aspirin-sized tablets per compartment, and up to 24 daily alarms
• Access: a self-locking window opens only at scheduled times; two keys included
• Power and size: 4 AA batteries, 6 to 12 months stated, low-battery warning; 10 x 9 x 8 in, 2.8 lb

Filling, alarms and everyday care

Choose one person to fill the tray, on the same day each week or fortnight. Fill it at a clear table with the pharmacy list in front of you, one medicine at a time, and lock the lid before you leave.

Set the alarms with the person who will hear them, so the times fit real mornings and evenings. Say your father sleeps until nine: a seven o'clock alarm will ring to an empty room. Agree what happens if he is out when it sounds.

• Write the fill date and the next fill date on a card beside the unit
• Keep the medicine list next to the dispenser for visiting helpers
• Store it in a dry room away from a sunny window
• Change batteries at each low-battery warning, not later

Common mistakes and when to ask for help

The real limit is this: a locked dispenser keeps the pills at home. MedlinePlus points out that you cannot take medicine out of it, which can be a problem when you go out. Plan a small travel box, filled by the same helper, for days away.

If doses are still missed with an alarm, or the person feels confused about the tray, speak to the doctor or pharmacist. MedlinePlus notes a provider may be able to reduce or simplify medicines. An occupational therapist can also look at the routine at home.

Watch the first two weeks closely. Call or visit at a dose time, and check the tray on fill day: an untouched compartment tells you more than a question on the phone. Ask the person, "Is the alarm too loud, too quiet or at the wrong time?"

• Filling it without asking the pharmacist which medicines may come out of the pack
• Picking a tray too small for the number of daily doses
• Keeping the only key with the person who uses the dispenser
• Forgetting to refill the dispenser after a medicine change