Not taking medications as prescribed can have devastating consequences
Sometimes we find it difficult to take medications as prescribed.
We’re not necessarily convinced the medicine is working or is effective, or we fear the side effects. If it’s in an injection or via inhaler or other obtrusive delivery method, perhaps we face repeated discomfort from taking the medication.
And for those of us who cannot afford the high pricetag of prescription medicines, or struggle to keep up with complex dosing schedules for multiple medications, we may simply throw our hands up in the air and give up.
Medication adherence is one of the most difficult tasks for Americans to achieve. Only about half of patients in developed countries take their medications as prescribed and follow other agreed-upon lifestyle and dietary changes, according to World Health Organization estimates.
This poor adherence leads to heightened risks for a variety of life-threatening conditions, from high blood pressure and high cholesterol to asthma and diabetes, says Dr. Christopher Roller, a pharmacist at the Central Utah Clinic.
“Taking the appropriate medication is important, but equally important is taking the medication correctly and consistently,” Roller says.
Failures to adhere to medication regimens fall into two main categories, with potentially life-threatening outcomes in both cases:
1. Chronic conditions: Complications from failing to take prescribed medications for high blood pressure, high cholesterol and diabetes can dramatically increase the risk of heart disease, stroke, kidney failure and other conditions, leading to disability, morbidity and mortality. “A small increase of only 20 mm Hg in systolic and 10 mm Hg in diastolic blood pressure can double your risk of stroke and ischemic heart disease,” Roller says. For patients with HIV/AIDS, a failure to take medications as prescribed could cause the virus to mutate and become resistant to medications, including alternative medications the patient may need to try in the future. This could result in fewer available treatment options.
2. Temporary antibiotic therapy: Although chronic diseases overshadow antibiotic therapy, a failure to take antibiotics as prescribed can decrease cure rates, increase the chances of developing antibiotic resistant strains of bacteria, and triple the likelihood of having to return to your doctor. When a patient stops taking the full course of antibiotics because he or she is feeling better, a small number of bacteria tend to survive, and as they multiply, these bacteria can become resistant to certain antibiotics. “This means more time and money spent trying to get well,” Roller says.
Despite all of the risks, many patients — even well-intentioned ones — continue to struggle to take their medications as prescribed. Roller offers the following tips for combating medication adherence failures:
1) Keep medications in a prominent place: If you need to take medications when you wake up or when you go to sleep at night, put them in your bathroom next to your toothpaste or deodorant, so you’ll remember to include them in your morning routine. If you need to take your medications with food, place your medications on the dining room table or the kitchen countertop.
2) Use daily dosing containers: If you’re juggling multiple medications, it can be hard to keep track of what you’ve already taken and what you still need to take. You’ll be surprised at how easy it is to take all of your medications if you physically divide them up by day. Instead of being burdened with opening every pill bottle every day, you can now open just one container and be done.
3) Take advantage of technology: From reminder wristwatches to automatic pill dispensers, and even voice-command medication managers, there are a number of highly tailored solutions to help you remember to take your medications on time. Furthermore, apps on your own smartphone can also help you with this important task, or you can set up your phone to automatically send you text-message reminders.
4) Alert your physician if cost is an issue: If you think you won’t take your medications because of their cost, you should ask your doctor for suggestions, such as prescribing a non-brand-name, generic version of the medication.
5) Talk to your pharmacist: Although your physician should be a key player in medication adherence, your secret weapon is your pharmacist. Most patients recall as little as 50 percent of what was discussed with their prescriber. Pharmacists can help you understand side effects and drug interactions, what to do if you miss a dose, and what foods may interfere with your medications. “Your friendly neighborhood pharmacist can be a vital source of education and support,” Roller says. “Pharmacists are able and willing to tailor your daily drug schedule to fit your lifestyle and personality.”
Poor medication adherence leads to too many unnecessary doctor visits, emergency room visits and hospitalizations that cost the U.S. health care system an estimated $300 billion a year, and claim the lives of 125,000 Americans annually.
Considering that breakthroughs in medical science are helping us to live longer, healthier lives, there’s simply no reason people should be at risk because they don’t follow simple instructions. Remember, combating adherence failures is a matter of keeping medications in a prominent place, using daily dosing containers, taking advantage of technology, alerting your physician about cost issues, and getting help from your pharmacist.