The answer is probably not your medicine cabinet. The answer may be your nightstand, kitchen counter, or a variety of other locations in your home. The question is, where do you store your prescription medications?
I became interested in medication adherence through my digital health research at Tufts University School of Medicine. My starting point was questioning why there was no significant impact on adherence from the use of digital devices and reminder aids. From there, my research assistants and I investigated the role of storage locations, since visual and auditory cues can work only if you can see or hear them. And that led us to the question of:
“Where do people store their prescription medications in their homes?”
Despite many homes having a medicine cabinet – and despite the name “medicine cabinet” – our research showed the variability in storage locations used. We deployed a survey in April 2021, and the 1,482 respondents aged 20 and older used 2.4 locations on average with the most common, at 41%, being the bedroom nightstand. The locations respondents used are shown in the table. Now we are exploring why people select storage locations, and how the determinants of selection correlate with self-reported adherence.
On this research journey, we have learned fascinating things. A professor of pharmacy told us he teaches his pharmacy trainees to recommend placing a pill bottle next to an object that is regularly used, known as habit stacking. The most common example he uses is recommending patients place pills they take in the morning or at night next to their toothbrush. When we asked a dentist about that, she laughed and said she wished her patients all brushed their teeth twice a day. She suggested we consider what people are actually adherent to, like their morning coffee.
The impact of poor medication adherence, however, is no laughing matter. Research shows that only 50% of people adhere to appropriate medication adherence guidelines. It is estimated that medication nonadherence causes as many as 125,000 deaths and between 33% – 69% of hospital admissions in the U.S. each year. As our research progresses and we uncover more about the relationship between storage locations and adherence, our longer term goal is to provide guidance that physicians and pharmacists can use with their patients as part of shared decision making. We would like to develop and test an intervention to initiate patient-provider discussions about home medication storage that lead to increased adherence. Another intervention will be developed and tested to reach patients and caregivers directly to guide their storage location selection. We are also designing innovative devices to aid with adherence that are tailored to specific locations in the home.
If you take prescription medication, consider the following: Where do you store your medication? Why do you store it there? You might try experimenting with new locations or with habit stacking to see if it increases adherence to your medication regimen.
Would you contribute to our medication adherence research? Contact Lisa at firstname.lastname@example.org.
Lisa Gualtieri, PhD, ScM is Associate Professor of Public Health and Community Medicine at the Tufts University School of Medicine. Her research focuses broadly on helping people to lead healthier lives. She runs an active Digital Health research group, and she thanks the students working with her on medication adherence who contributed to this post: Brandon Estime, Heather Kolnick, Meera Singhal, and Avi Patel. You can reach Lisa on Twitter @lisagualtieri.
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Keep them with you and set an alarm to take them
Put it in the closet. Put a label on the outside
I set up a schedule on my phone,