medication-reminder

name	medication-reminder
description	Manages medication schedules, tracks adherence (doses taken vs. due), identifies missed dose patterns, and monitors refill timelines. Use when the user logs medications, asks about adherence, or needs a medication schedule.
version	1.0.0
user-invocable	false
allowed-tools	Read, Grep, Glob, Write, Edit
metadata	{"openclaw":{"emoji":"💊","category":"health"}}

Medication Reminder

Manage multi-drug records, generate daily medication schedules, calculate adherence rates, identify missed-dose patterns, and track refill timelines.

Capabilities

1. Medication Record Management

Record fields:

Field	Description	Example
Drug name	Generic or brand name	Amlodipine / Norvasc
Dose	Single dose	5mg
Frequency	Frequency code	QD / BID / TID / QID / QW / PRN
Timing	Timing code	AC / PC / HS / AM / PM
Start date	Start date	2026-01-15
End date	Stop date (optional)	2026-06-15 or empty
Prescriber	Prescribing physician (optional)	Dr. Zhang
Notes	Special instructions	Do not take with grapefruit

Frequency codes:

Code	Meaning	Daily doses
QD	Once daily	1
BID	Twice daily	2
TID	Three times daily	3
QID	Four times daily	4
QW	Once weekly	1/7
Q2W	Every two weeks	1/14
QM	Once monthly	1/30
PRN	As needed	Not included in adherence

Timing codes:

Code	Meaning	Suggested time
AC	Before meals	30 min before meal
PC	After meals	30 min after meal
HS	At bedtime	30 min before sleep
AM	Morning	After waking
PM	Afternoon	14:00-16:00
EMPTY	Fasting	1 hour before breakfast
WITH_FOOD	With food	During meal

Operations: Add, discontinue (set end date to today, preserve history), modify (record change history), list current medications.

2. Adherence Calculation

Formula: Adherence rate = (actual doses taken / doses due) * 100%

Dimensions:

Dimension	Calculation
Daily	Today's taken / today's due * 100%
Weekly (7-day rolling)	Past 7 days total taken / total due * 100%
Monthly (30-day rolling)	Past 30 days total taken / total due * 100%
Per-drug	Drug's taken / drug's due * 100%
Overall	Weighted average across all drugs

Doses due: Derived from frequency code and active date range. PRN drugs excluded from adherence calculation. Only count doses within the drug's active period.

Adherence grades:

Rate	Grade	Interpretation
>= 80%	Good	Regular adherence, maintain current pattern
50-79%	Fair	Frequent misses affecting efficacy; analyze causes, set reminders
< 50%	Poor	Severe non-adherence; discuss regimen simplification with physician

Steps:

1. Read memory/health/items/medications.md for drug list
2. Glob memory/health/daily/*.md for the target date range
3. Extract ## Medications sections from daily files
4. Per drug: count doses due vs. doses taken
5. Output adherence by all dimensions

3. Missed Dose Pattern Identification

Time-of-day pattern: Compare completion rates across time slots (morning / midday / evening / bedtime). Flag any slot with rate significantly lower than others.

Day-of-week pattern: Compare daily completion rates Monday through Sunday. Flag if weekends are notably lower than weekdays.

Drug-specific pattern: Compare per-drug adherence. Flag any drug with adherence notably below overall average (by 20%+). Possible causes: side effects, inconvenience, forgetting.

Steps:

1. Extract medication time and status from daily records
2. Aggregate by time-of-day / day-of-week / drug
3. Compute completion rates per dimension
4. Flag dimensions significantly below average (20%+ lower)
5. Output pattern descriptions and improvement suggestions

4. Daily Schedule Generation

Generate today's medication schedule from the active drug list.

Time-slot ordering:

1. EMPTY / AM -- morning fasting (~07:00)
2. AC (breakfast) -- ~07:30
3. PC (breakfast) / WITH_FOOD -- ~08:00
4. AM other -- ~08:30
5. AC (lunch) -- ~11:30
6. PC (lunch) -- ~12:30
7. PM -- ~15:00
8. AC (dinner) -- ~17:30
9. PC (dinner) -- ~18:30
10. HS -- ~21:30

Multi-dose distribution: BID = morning + evening; TID = morning + midday + evening; QID = morning + midday + evening + bedtime.

5. Common Drug Interaction Alerts

Flag the following known high-risk combinations when a new drug is added:

Combination	Risk
Warfarin + NSAIDs	Increased bleeding risk
ACEIs + Potassium-sparing diuretics	Hyperkalemia risk
Statins + Macrolides	Rhabdomyolysis risk
Metformin + Iodinated contrast	Lactic acidosis risk
Digoxin + Amiodarone	Digoxin toxicity risk

For comprehensive interaction checking, recommend the user run a dedicated drug-interaction-checker skill or consult a pharmacist.

6. Refill Tracking

Remaining supply: Remaining days = remaining tablets / daily doses

Reminders:

• Remaining <= 7 days: "Running low" reminder
• Remaining <= 3 days: "Urgent refill" reminder
• Remaining = 0: "Out of stock" alert

Output Format

Daily Medication Schedule

# Daily Medication Schedule

## Date
YYYY-MM-DD (Day of week)

## Today's Plan

### Morning (07:00-08:30)
| Time | Drug | Dose | Requirement | Status |
|------|------|------|-------------|--------|
| 07:00 | Levothyroxine | 50ug | Fasting, 1h before meal | [ ] |
| 07:30 | Metformin | 500mg | With food | [ ] |
| 08:00 | Amlodipine | 5mg | After meal | [ ] |

### Midday (11:30-12:30)
| Time | Drug | Dose | Requirement | Status |
|------|------|------|-------------|--------|

### Evening (17:30-18:30)
| Time | Drug | Dose | Requirement | Status |
|------|------|------|-------------|--------|

### Bedtime (21:30)
| Time | Drug | Dose | Requirement | Status |
|------|------|------|-------------|--------|

## Summary
- Total: N drugs, M doses
- Special notes: [e.g., Levothyroxine must be taken fasting, 1h apart from others]

## Refill Alerts
- [Drug]: N tablets remaining (~N days), refill soon

Adherence Report

# Adherence Report

## Period
YYYY-MM-DD to YYYY-MM-DD (N days)

## Overall Adherence
- **Rate: N% (Good/Fair/Poor)**
- Doses due: N
- Doses taken: N
- Doses missed: N

## Per-Drug Adherence

| Drug | Dose | Freq | Due | Taken | Rate | Grade |
|------|------|------|-----|-------|------|-------|

## Missed Dose Patterns

### Time-of-Day Analysis
| Slot | Rate | Assessment |
|------|------|-----------|

### Day-of-Week Analysis
| Sun | Mon | Tue | Wed | Thu | Fri | Sat |
|-----|-----|-----|-----|-----|-----|-----|

### Drug-Specific Analysis
- [Drug with low adherence]: [analysis]

## Improvement Suggestions
1. [specific, actionable suggestion]

Data Persistence

Follow health-memory write protocol:

1. Update daily file: Insert/replace section ## Medications [medication-reminder · HH:MM]
2. Update items file (memory/health/items/medications.md):
   • Update ## Current Medications table
   • Update ## Recent Status: today's adherence, 7-day, 30-day, next refill
   • Prepend row to ## Adherence History table
   • Trim rows older than 90 days

Items file structure:

---
item: medications
unit: n/a
updated_at: YYYY-MM-DDTHH:MM:SS
---

# Medication Records

## Current Medications
| Drug | Dose | Frequency | Timing | Start | End | Notes |
|------|------|-----------|--------|-------|-----|-------|

## Recent Status
- Today's adherence: N% (N/N doses taken)
- 7-day adherence: N%
- 30-day adherence: N%
- Next refill needed: [drug] (N days)

## Adherence History
| Date | Due | Taken | Missed | Rate | Missed Details |
|------|-----|-------|--------|------|----------------|

Daily section format:

## Medications [medication-reminder · 21:00]
- Taken: Amlodipine 5mg (AM), Metformin 500mg x2 (AM, PM), Valsartan 80mg (HS)
- Missed: Atorvastatin 20mg (PM)
- Today's adherence: 83% (5/6)
- Refill alert: Metformin 6 days remaining

Alerts and Safety

Safety Rules

• Any medication change (add/stop/adjust dose) must follow physician orders
• Do not double up on missed doses without consulting a physician or pharmacist
• Interaction alerts in this skill are for reference only; consult a pharmacist for comprehensive checks
• Stop medication and seek medical attention immediately if adverse reactions occur

Consult a Physician/Pharmacist When

• Adherence is persistently below 50%
• Frequently missing the same drug (may indicate side effects)
• Taking 5+ concurrent medications
• Concerned about interactions when adding a new drug
• Experiencing any suspected adverse reactions

Medical Disclaimer

This skill is for medication recording and reminder reference only. It does not constitute medical advice. It does not prescribe, recommend adding or removing medications, adjust dosages, or replace a pharmacist or physician.