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Adherence, compliance and concordance

Alexa’s medicine reminders can be 'distressing' for dementia patients

Amazon Alexa device


Thinktank Doteveryone said that using virtual assistants — such as Amazon’s Alexa device (pictured) — to support home-based care may not take into account a patient’s additional needs, such as dementia or learning disabilities

Patients with dementia can be “deeply distressed” to receive medication reminders from Alexa-type devices, according to technology thinktank Doteveryone.

In its report, ‘Better care in the age of automation’, which was published on 23 September 2019 and explores how technology can be used “responsibly and effectively” in the care sector, Doteveryone said that using virtual assistants to support home-based care may seem sensible, but it does not take into account any additional needs of patients with dementia, learning disabilities or physical conditions that affect speech.

Lydia Nicholas, programme manager at Doteveryone, wrote a blog on the report. “The job of reminding someone to take their medication involves a lot more than the task of saying ‘time to take your medication’,” she said.

“It may involve convincing someone with dementia, who is confused and distressed, that their medication is safe,” she added.

The report also concluded that if NHS appointment reminders are sent by text message, then that text should be checked for readability and the NHS must ensure that it works with text-to-speech software.

Potential problems such as these are often invisible to people who have not experienced illness, disability or caring, the thinktank said.

The report also said that care providers are “incentivised to use technology to cut staff”, or to track carers’ movements to ensure they meet cost-based targets.

It suggests that an alternative vision would include the use of data to measure patient wellbeing and productivity.

Citation: The Pharmaceutical Journal DOI: 10.1211/PJ.2019.20207097

Readers' comments (1)

  • Medication administration in people with intellectual/learning disabilities is a complex, high risk healthcare intervention.

    Pharmacists should be aware of the role of any person administering medication i.e. parent, family member, nursing staff, unregulated care staff, care staff with no very limited training in medication administration, care with no training.
    This will impact on their knowledge of medications, medication interactions and adverse events etc.

    The overall incidence of adverse reactions to medications in the population with intellectual/learning disabilities is unknown.

    Medications can be prescribed, dispensed and administered across the boundaries of primary and secondary care.

    Multiple medication use and multi-morbidities is a fact.

    Adverse reactions to medications may be unrecognised because some are not easy to determine in people who have limited communication abilities/skills.

    The task of multiple medication administration may seem to be a 'simple task' to those not involved in the process.
    People with multiple prescriptions may require the administration of medications in numerous forms: solid tablets/capsules, liquids, contents of sachet dissolved in water, nebulisers, insulin injections, topical creams, patches, ear/eye drops, injections, PEG feeding plus plus

    Swallowing difficulties, behaviour issues, legal considerations etc. all may also play a part.

    Ref: Flood,B. 2016. Medication use in residential care for older people with intellectual disabilities. Learning Disability practice, 19,7,24-29.

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