Interventions and tools to help improve medication adherence, where manual dexterity (capability) has been identified as a factor

Difficulty opening containers

Many of these aids are available on prescription or free from pharmacies, or from manufacturers. 

Use of an alternative container

When considering alternative containers, consideration should be given to the pharmaceutical stability of the medication outside its original packaging. 

Larger bottles and lids

Larger bottles and lids can improve grip for some patients. Check whether a medicine can be used out of its original container.

Non-childproof medication lids

Non-childproof medication lids can be used on medication bottles instead of the standard childproof lids. A pharmacist can supply these after providing guidance on storing medication out of reach of children.

Pill bottle openers 

Pill bottle openers can be useful for the elderly or people who have a weakened grip. The design of these enables a firm grip and eases the downward pressure and twisting of childproof enclosures. There are a number of products available online.  

Difficulty opening blister or foil packs 

Some blister packs are peelable, and pharmacy staff should check and advise patients accordingly if they are having difficulty getting their medicines out of the packaging.  

There are a number of products available online e.g. Personal Poppitt Pill Remover or Medi-Popper. 

Difficulty using liquid medicines 

For patients taking liquid medicines who cannot easily measure a dose using a spoon, an oral syringe may be preferable if they are able to use it. Pharmacies can provide these. 

It might be useful to consider whether a tablet formulation may be preferable over a liquid formulation in patients that struggle with using spoons or oral syringes. 

Difficulty using eye drops  

People may have difficulty with instilling eyedrops in the correct position, squeezing the eye bottle or administering the drops due to mobility, hand to eye coordination or dexterity in general.   

Assess the difficulty the patient has before advising on suitable options.  

Moorfields Eye Hospital NHS Foundation Trust has a useful guide which details other eye drop dispensers and includes which eye drop bottles each can be used with which device.  

The Royal National Institute of Blind People has various eye drop dispensers available and a helpline that will help the patient choose the right option.  

Some eye drop dispensers are available from manufacturers of eye drops (e.g. Alcon Eyoti, Celluvisc Compliance aid and the ComplEye) 

Difficulty using inhalers

There may be a more suitable inhaler type available depending on the patient’s difficulty. A spacer device can help with problems related to dexterity or co-ordination with breathing after inhaler actuation. The RightBreathe website can be used to check options.

If a suitable alternative is not available, inhaler aids are available that help patients grip, actuate or twist their inhaler device. Search ‘inhaler aid device’ online for options available. Once a suitable device has been identified check if it is compatible with the patient’s inhaler.

Many inhaler aids are available free directly from manufacturers, with some being available from community pharmacies.

Difficulty using creams and ointments  

There are a number of aids to assist squeezing creams and gels from tubes. Some are tube squeezers that are placed over the end of the tube and slide down to encourage dispensing.  Others have a key turn action with suction cups on the bottom to secure to any flat surface. 

There are a variety of products available that can help with the application of topical products. Applicators can be filled with creams or ointments and have rotating balls to ensure even distribution of product on to the skin. Other applicators feature an ergonomically designed handle and head that flexes to match the exact contours of the back to enable application to this hard-to-reach area.  

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