Pill boxes may do more harm than good

Pill boxes given out by pharmacists to help patients manage their medication ‘may do more HARM than good’

  • Before patients are given pill boxes, many take their medication ‘sporadically’
  • If doctors notice no improvement to a patient, they may up their drug dose
  • Once a patient starts taking this dose, they may suffer dangerous side effects 

Pill boxes given out by pharmacists to help patients manage their medication may do more harm than good, research suggests.

A study by the University of East Anglia found patients are more likely to end up ill or even in hospital when they switch to the medication dispensers.

Pill boxes sort medication according to the day it needs to be taken, with some also having timers or alarms that notify patients to take their drugs.  

Before patients are given pill organisers, many take their medication ‘sporadically’, with doctors noting no improvement to their health, the researchers claim.

Medics may then up their dose to get the ‘desired’ health outcomes, only for the patients to suffer dangerous side effects as a result, they added.

Pill boxes given out by pharmacists may do more harm than good, research suggests (stock)

‘A lot of people use pill organisers to help them take the right medication at the right time of the day,’ lead author Dr Debi Bhattacharya said. 

‘Our research showed patients were more likely to become unwell when they switched from taking their medication straight from the packet to using a pill organiser.

‘In some cases, older people can even end up being hospitalised.’

‘This is likely because when the patients had been taking their medication sporadically, they weren’t getting the expected health improvements.  

‘Their doctor may therefore have increased the dose of the medication to try to get the desired effect.’

Writing in the Research in Social and Administrative Pharmacy journal, the researchers claim pill boxes can also be confusing. 

If a patient accidentally or purposefully skips a dose, they may struggle to pick where they left off, the authors claim.

‘This can lead to serious health complications’, Dr Bhattacharya said.

The researchers warn pharmacists are not considering the potential side events of a patient suddenly taking too high a dose of their medication.

This may be concerning given that pharmacies are doling out twice as many pill boxes as they were 10 years ago, the study found.


Pill boxes were created to help patients manage their medication.

Pharmacists can sort different drugs according to the day of the week an individual is supposed to take them.

Once home, the patient just needs to open the compartment for that day of the week.

Some dispensers even have alarms to notify patients its time to take their drugs. 

Other boxes have timers that cause the compartment lids to open automatically.

The dispensers could help patients who have a lot of drugs to take or who suffer with poor memory. 

The researchers have issued guidelines that recommend patients first be offered easy open medicine bottles.

Coloured labelling could also be used to highlight when to take a drug.

The Medication Adherence Support Decision Aid (MASDA) guidance is endorsed by the Royal College of Physicians and the Royal Pharmaceutical Society. 

The researchers hope it will be adopted by the NHS. 

‘Our new algorithm encourages prescribers to consider the emotional and practical barriers that might stop patients taking their medication correctly,’ Dr Bhattacharya said.

Emotional barriers include a patient feeling anxious or lacking confidence, as well as poor motivation to take a drug that may cause side effects.

In such cases, medication-compliance aids, like pill boxes, may be inappropriate, the guidelines state.

Instead, social support may help boost a patient’s confidence or doctors could explain how the benefits of a drug outweigh its side effects, the researchers claim.  

Patients with practical barriers, such as poor vision or memory loss, may benefit from a pill box, however, other solutions should be tried first, the researchers claim.

They stress those who are already using a pill dispenser successfully should not suddenly stop.

‘People who are already using a pill organiser without any ill effects should not stop using it as they do seem to help some patients take their medication as prescribed,’ Dr Bhattacharya said.

‘It’s the switching stage which appears to be the danger.’

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