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Objective: To assess the usefulness of the Practidose individualised dispensing and dosing pillbox system in improving treatment compliance (TC)., Design: Open-labelled, randomised, clinical trial., Setting: Cordoba province from April to September 2005., Participants and Context: A total of 220 patients 70 years diagnosed with ineffective management of treatment regime, polymedicated with no cognitive deterioration or limited mobility. Enrolment was carried out by block random assignment. Each district linking nurse was assigned 10 interviews, 5 from the intervention group and 5 from a control group., Intervention: To give a smart pillbox with instructions. MEASUREMENTS AND PRIMARY OUTCOMES: The response variable was the TC measured using the Morisky-Green questionnaire at the beginning and at 2 months. The independent variables were: age, sex, education level, number of people living in the home and mean age, diabetes, hypertension, heart disease, COPD, number of medications, number of daily and weekly doses self-medication, and interest in the patient information leaflet. A descriptive analysis and a multiple logistic regression were performed on the data. A total of 182 patients finished the study. The TC improved by 6.74% in the intervention group and by 2.15% in the control group. To look after the medications and suffer from COPD lead to better TC, and was less so when there was interest in the patient information leaflet., Conclusions: The improvement in treatment compliance with the Practidose Pillbox was not statistically significant, although a positive tendency was observed.

Objectives: To ascertain and analyse the drug consumption of the immobile elderly, as well as the number of potentially inappropriate medications (PIM)., Design: Cross-sectional study., Setting: Fourteen rural primary care centres., Participants: Non-institutionalised immobile patients, older than 64 years were selected by systematic sampling., Principal Measurements: Review of patients' medicine cabinets and noting the daily doses and current number of drugs, as well as the origin of the prescription. Identification of PIM (Beers criteria)., Results: One-hundred forty-three homes visits were made. The mean age was 81.3+/-7.9 years, of whom 74.8% were women. The most common drugs were: analgesics (9.2%), antacids (7.1%), nitrites-calcium antagonists (6.5%), non-steroidal anti-inflammatories (5.0%), and angiotensin converting enzyme inhibitors (4.7%). The percentage of patients who took more than 4 drugs was 76.1%. A PIM was taken by 35% of the elderly. The most common were: long-acting tranquilisers (41.5%), hypnotics (13.8%), digoxin (13.8%), indomethacin (7.7%), and antispasmodics (6.1%). In the majority of cases, the prescribing of the PIM was made by the family doctor (77.7%). Women took significantly more inappropriate drugs than men (0.50+/-0.72 vs to 0.25+/-0.50; P=.001) and those on multiple medication more than those not on multiple medication (0.50+/-0.73 vs 0.31+/-0.52; P=.008)., Conclusions: The prevalence of inappropriate therapy in the immobile elderly is high, therefore an effort must be made to reduce it. Procedures directed towards increasing the quality of prescribing could improve the state of health and quality of life of these patients.