The sorry state of medication reminder software

I use an app called Medisafe to give me my medication reminders. It’s useful because it tracks my doses and also tracks how much I have left so I know when to order refills and so on. I’ve been using it for years.

Unfortunately it has a critical problem in that it only sends three easy-to-miss reminders spaced ten minutes apart with no way of configuring it. So often I’ll end up taking my medication a few hours later than the scheduled time, because I head to bed and notice the pending reminder that I meant to fulfill.

In this past week I’ve forgotten to take my nightly nortriptyline twice, once on Thursday night and once last night. With the Thursday night incident I woke up at 5 AM feeling really off and when I saw the pending reminder for medication I realized what had happened, so I took a half dose right away. The Saturday night incident, I had convinced myself that I had really taken it, and just forgot to clear the reminder — which is also easy to do with Medisafe.

So today I’ve felt like absolute garbage.

Unfortunately, Medisafe is the least-bad app I’ve found for medication tracking. Most apps are only very simple reminder timers which don’t even try to send repeat notifications, or their dosing schedules are incredibly limited (like you can only set “take every 12 hours” and not “take at a specific time of day”) or they don’t do very good jobs of handling dosage/schedule changes. Not that Medisafe is great about this either; it gets very confused if you change time zones, or if you add or remove a dose during a day when you’ve already taken the first dose for that medication, for example.

The only medication I ever have trouble remembering to take is my evening nortriptyline, but unfortunately that’s the one that has the worst issues if I forget to take it. Most of my meds I can skip for a day or two and it won’t be a problem, but missing a dose of this is quite debilitating. And unfortunately it’s always at an awkward time of night where I have something else going on.

Part of the problem also is that iOS tries to automatically infer when app notifications are “spammy,” and unfortunately Medisafe reminders always seem to trigger that, since they’re duplicates sent at regular times. iOS also doesn’t let you disable that “helpful” behavior, and apps are also very limited in the sorts of reminders they can send in the first place. They can’t set off a system alarm, for example, and if they make a sound they’re limited only to a handful of short built-in sounds or the ability to play custom sounds that come with the app — and none of those are ever very good (and I usually have my phone on vibrate anyway).

Since this keeps on happening I’ve decided to take the approach of setting an actual system alarm to go at 9:10 PM, and just promise myself to only snooze it until I’ve actually taken the medication. But that requires putting a lot of trust in myself.

When I ranted about this problem on Mastodon, several people helpfully brought up the idea of just using a pill organizer, but that doesn’t really work for me either; I used one for a while and found that it wasn’t very helpful. Having to do a weekly refill of it was annoying, and while that would remove any ambiguity as to whether I took a medication or not, it still doesn’t help to notify me when the medication needs to be taken.

There are also pill containers with built-in timers but that presupposes that I keep my meds with me all the time (and not just in my bedroom where they belong), and also I can just see myself letting the battery run out and then not bothering to change it.

There needs to be a better way for this stuff to happen, that’s compatible with ADHD folks and others who are easily-distracted and have trouble remembering mundane things.


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