How to Set Up a Weekly Medicine Box Without Mistakes

Before you begin: the medicine list

Everything starts with an accurate, current list of what your parent takes. Without it, you are filling from memory, which is how mistakes happen.

Make the list from reliable sources:

• the latest prescription or discharge summary;
• the medicine strips and bottles in the house;
• the pharmacist's printout, if available; and
• any changes the doctor made at the last visit.

For each medicine write:

• the name (brand and generic if both appear), and what it is for;
• the strength and the number of tablets per dose;
• the times of day;
• special instructions, such as before food, with food, avoid milk or take with a full glass of water;
• the start date and the doctor who prescribed it; and
• the date the supply will run out.

Include everything: prescription tablets, creams and drops (which do not go in the box), supplements, herbal and Ayurvedic products, vitamins and over-the-counter medicines. Tell the doctor about all of them, because they can interact.

Keep one copy in the box area and one in your parent's wallet or phone. Update it every time the doctor changes a dose. See keeping a health record at home.

Choose a good time and place

• Same day and time each week, when you are not rushed or tired, such as Sunday morning.
• A clean, flat, well-lit surface, such as a table, with a clean cloth or tray to catch dropped tablets.
• No distractions. Switch off the television and the phone, and ask others not to interrupt.
• Hand washing first, and dry hands.
• A small container for dropped tablets, so they are not lost or put back wrongly.
• Good eyesight. Use a magnifier or reading light if needed; see magnifier lamps.

Step by step

1. Gather everything: the organiser, the medicine list, all the strips and bottles, a pen and a cloth. 2. Check the organiser: empty, clean and dry. Wipe out any crumbs or powder. 3. Check each medicine against the list, one at a time. Look at the name, strength and expiry date on the packet, and make sure it matches the list. 4. Fill one medicine at a time across the week. Take the first medicine, and put the correct dose into each day and time on the list, for all seven days. Then put that medicine away and take the next. This is safer than filling day by day with all medicines out, because it keeps your attention on one medicine at a time. 5. Count as you go, and check the number left in the strip or bottle: it should match what you expect. 6. Tick each medicine on your list when done for the week. 7. Close all the lids and check. Go through the box day by day, comparing the contents with the list. Count the total number of tablets for each time slot. 8. Do a second check if possible, by another adult, particularly for complex regimes, or check again an hour later. 9. Put medicines away in a cool, dry place, out of children's reach, and out of direct sun. 10. Note on a chart the date and who filled the box. 11. Order refills for any medicine that will run out in the next two weeks.

Things to watch for

Look-alike and sound-alike medicines. Different medicines can look similar, and names can be confusingly alike. Read each label, not just the shape and colour. Keep each medicine in its original strip until needed, so the name stays with it.

Different strengths of the same medicine. A doctor may prescribe half a tablet or two strengths. Make sure you use the right one.

Half tablets. Only split tablets that are meant to be split, and use a tablet splitter. Keep the unused half in the strip or in a closed container.

Tablets that must not be crushed or split. Extended-release, coated and some other tablets are designed to be swallowed whole; ask the pharmacist.

Medicines taken "as needed". Keep these separately, labelled, and not in the box.

Time-critical medicines. Some medicines, such as those for Parkinson's disease, diabetes and anticoagulants, depend on exact timing and doses. Ask the doctor and see medicine timing in Parkinson's.

Interacting foods and drinks. Some medicines are affected by milk, calcium, grapefruit, alcohol or high-vitamin-K foods. Follow the doctor's and pharmacist's instructions.

Changes. When the doctor changes a dose or adds a medicine, update the list and refill the box immediately. Remove stopped medicines from the house.

Mistakes to avoid

• Filling from memory instead of the list.
• Filling while distracted, tired or in poor light.
• Mixing medicines from two people on one tray.
• Topping up a half-full box from a new bottle without checking the old contents.
• Pre-filling several weeks in advance, which compounds any mistake and delays changes.
• Putting loose tablets in without their packaging and later forgetting what they are.
• Storing the box in a hot or damp place, such as a bathroom or kitchen window.
• Not telling the doctor about missed doses or side effects.
• Double dosing because a dose was forgotten and later found.
• Ignoring expiry dates.

What to do if you find a mistake

If you notice you have filled a wrong tablet, simply empty the compartment, check the list and refill. If your parent has already taken a wrong or double dose, do not panic, but act: check the leaflet, call the pharmacist or the doctor, and describe what was taken and when. For serious symptoms such as drowsiness, collapse, severe breathlessness, chest pain, confusion or low blood sugar, call 112. Keep the packaging to show the doctors. Report errors so the system can be fixed.

Travel and outings

For a day out, use a small day organiser or a labelled pill pouch with the exact doses for the day. For longer trips, take the weekly box and a copy of the list, and carry extra medicines in hand luggage in the original packaging. Do not pack medicines in checked baggage. Keep a copy of the prescription and the doctor's contact details. Be careful with time zones and travel days; adjust with a doctor's advice. See travelling with an elderly parent: a checklist.

Involving your parent

If your parent is capable, let them take part: read out the list, check the names and fill with you. This keeps them informed and independent, and often catches errors. If they cannot, explain what you are doing and why. Treat medicines with respect; avoid talking about tablets as if your parent were a child.

Monitoring that goes with the medicines

Some medicines need checks: blood pressure, blood sugar, pulse or weight. Keep a simple log with the date, time and reading, and bring it to the doctor; see blood pressure monitors, how to test blood sugar at home and blood pressure log and what to tell the doctor.

When to ask a professional

Ask a pharmacist to review the list, check interactions and advise which medicines can go into an organiser. Ask the doctor for a medicines review at least once a year and after every hospital stay, to stop what is no longer needed; see polypharmacy and deprescribing. Ask a nurse to set up the first box and teach the routine. Our care advisors can arrange a nurse visit for medicine set-up and reviews.