NAME

GENDER
AGE
OCCUPATION
DESEASE IF ANY
YES/NO

MEDICATION

TYPES OF DESEASE
1.CHRONIC OR ACCUTE

Q.17
15
16
5
6
8

FREQUENCY OF DOSAGE

30
31

PRODUCT DESCRIPTION
PRICE
WILLING TO PAY
WILLING TO BUY

USAGEE
HOW IT WILL BE HELPING ON A SCALE 5 STAR RATING

CARE TAKER

Q1.How often do you take pills?

(any kind of prescription for any kind of doctor's instructions)
 On a daily basis
On a weekly basis
On a monthly basis
Less often Q2.Do you manage medication for someone else?
I don't take any kind of pills
Yes
No

Back to summary
We would like to know a little bit about how your medication requirements to better understand how a medication
dispenser should aim to help.
Q3.How many pills do you or does the person you manage medication for take(s) daily?
Please fill out the table below with your daily intake (numbers only):

Period of the day Number of pills taken

Waking Up

Breakfast

Morning

Lunchtime

Afternoon

Dinner

Evening

At bedtime

Through the night

Q4.Where do you or does the person you manage medication for take(s) pills?

Home Work Other I don't take pills at this time

Waking Up

Breakfast

Morning

Lunchtime

Afternoon

Dinner

Evening

At bedtime

Through the night

4. Organising your medication
Back to summary
Q5.Do you organise your pills into doses prior to taking them? (or for the person you manage medication
for)

Yes, per dose

Yes, daily
Yes, weekly
Yes, monthly

Yes but less frequently, please specify the frequency: 

No, I don’t organize my pills

5. Organising your medication

Back to summary
Q6.What kind of mistakes do you make?
Forget to organise
Get confused between different types of pills
Put pills in wrong dose
Drop medication

Other, please specify: 

I do not do any mistake
Q7.Are there any specific problems you have with organizing you medication (or the medication of the
person you assist)?

I don’t have any problems

Understanding doctor’s instructions is difficult
Understanding pharmacist’s instructions is difficult
Understanding instructions on medication is difficult

Other, please specify: 

Q8.Who organises it for you?

No one, I do it myself
Your partner
A close family member
A friend
A neighbour
Pharmacist
A care assistant

Other, please specify: 

Back to summary
Q9.Where do you organise your pills (or the pills of the person you assist)?
In kitchen
In bathroom
At dining table
On bed side table
Sitting in front of TV
 Other, please specify: 
Q10.Where do you keep your medication (or the one of the person you assist) once you have organized
it?
Kitchen cupboard
Kitchen drawer
Bed side table
Bathroom cabinet

Other, please specify: 

Back to summary
Q11.Where do you take most of your medication? (or where does the person you assist do it)
In bed
In the bathroom at home
In the kitchen at home
At work

Other, please specify: 

Q12.Do you (or the person you assist) take(s) your pills to work?

Yes
No
Q13.How do you transport your medication? (or the medication of the person you assist)

In a bag
In your pocket

Other, please specify: 

Q14.Are you (or is he/she) concerned about taking medication in public?

Yes, please comment the reason: 

No

Back to summary
Q15.In the past have you ever had a problem remembering to take your medication?

Yes
No

9. Remembering to take your medication

Back to summary
Q16.Has this ever lead to side effects or otherwise concerned you in any way?

Yes, please specify: 

No

Back to summary
Q17.Do you (or the person you assist) currently use any of the following techniques as a reminder?
Note on fridge
 Watch
Phone alarm
Online reminder service

Other, please specify: 

Do not use any techniques as a reminder

Back to summary
Q18.Do you (or the person you assist) currently use a pill dispenser?

Yes
No
12. Previous experience of medication dispensers

Back to summary
Q19.Does your dispenser allow the medication for one day to be removed and carried around?

Yes
No
13. Previous experience of medication dispensers

Back to summary
Q20.Of the following features what do you like most/lease about your/the portable dispenser?

Small More hassle

I have my medication It helps me remember when It's fiddly It won’t fit in
compact than it’s Other
with me all the time to take my my medication to use my pocket
size worth

Most

Least
*Next step for the respondent : Next Page
14. Previous experience of medication dispensers

Back to summary
Q21.Do your pills (or the medication of the person you assist) all fit in your/the dispenser?

Yes

No, please specify the number of pills that do not fit: 

Q22.Thinking about the size of your/the pill dispenser:

Too big?
Too small?
Just right

Other, please specify: 

Back to summary
Q23.Have you (or the person you assist) ever used a pill dispenser?

Yes, please specify why you stopped: 

No, please specify why you don’t use a pill dispenser: 

16. Technology
Q24.How do you currently use your desktop computer/laptop?
Browse the internet
Send and receive email
Check social networking sites (Twitter, Facebook)
Online shopping
Print documents
Other
Q25.How do you currently use your smart phone?
Send and receive text messages
Send and receive emails
Browse the internet
Check social networking sites (Twitter, Facebook)
Synchronise with a computer
Use a bluetooth headset/hands-free kit
Install an application
Other
I don't have any smart phone

17. Product Description

Back to summary

The product is a compact medication holder with 7 daily dispensers for holding a week’s worth of medication.

An easy to use smart phone app provides medication information in an accessible, standardized format.

It eliminates confusion by guiding the user through the process of organizing weekly medication into the
medication holder.
When medication is due, the phone issues an unobtrusive audible or tactile alert, just like receiving a text
message.

It then indicates precisely which dosage to take.

Back to summary
Q26.How much would you be willing to pay for this product?

Not willing to buy

£0 – 10
£10 – £20
£20 – £30
£30 – £40
£50 – £100
£100 – £200
£200 – £300
£300 – £400
£200 – £300
£500+

Q27.Of the following features, what would you find most/least valuable?

Space for 1-week of Reminder Pocket Stylish/fashionable Discrete

Portability
medication doses function size design reminders

Most

Leas
t
Q28.How likely would you be to buy this product?

Very likely
Likely
Not sure
Unlikely
Very unlikely
19. Would you buy one?

Back to summary
Q29.What would make you more inclined to buy this product?

Q30.What is most important to you when buying a pill dispenser?

Cost
Features
Functionality
 Stylish/fashionable design
Size
Q31.When would you be most likely to use this product?
On holiday
At home
At work
In the car

Other, please specify: