Manual dexterity: supporting adherence

Difficulty opening containers

Many aids for opening containers are available on prescription or free from pharmacies, or from manufacturers.  

Use of an alternative container

When considering alternative containers that are suitable for storing medicines, 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 stored outside 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 people who have a weakened grip. The design of these enables a firm grip and eases the downward pressure and twisting of child-resistant closures. 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 that are designed to help, such as Living made easy’s Personal Poppitt Pill Remover or Medi-Popper (available from Independence Ltd.).  

Difficulty using liquid medicines  

For people 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 instilling eye drops in the correct position, squeezing the eye drop bottle, or administering the drops due to mobility, hand-eye co-ordination, or dexterity in general.

Assess the reason for the difficulty before advising on suitable options.

Eye drop compliance aids can help to administer eye drops correctly. Moorfields Eye Hospital NHS Foundation Trust has a useful eye drop compliance aid guide. This resource includes different eye drop compliance aids and which eye drop bottles can be used with each one.   

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

Some eye drop compliance aids are available from manufacturers of eye drops, such as Alcon Eyoti and ComplEye.

Difficulty using inhalers

There may be a more suitable inhaler type available for an individual depending on their 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 for inhaler and spacer 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 it is compatible with the individual’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 with 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 individual’s back, to enable application to this hard-to-reach area.

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