Hippocrates may have said it best, “Keep a watch on the faults of the patients, which often make them lie about the taking of things prescribed. For through not taking…they sometimes die.”
Now, most of us who miss a dose of prescribed medications aren’t doing it to intentionally lie, and even fewer of us miss a dose with the intent of dying, but the fact is Americans don’t, in general, do a good job of taking their medication. Studies show people miss doses of needed medications as much as 50% of the time; 25% of all new prescriptions are never even filled; and at least 10% of all hospitalizations could have been avoided if the patient had taken their prescribed medication as directed. Sadly, 125,000 deaths each year are caused by medication non-compliance. All total, the cost of medication nonadherence is $300 billion a year.
Former Surgeon General C. Everett Koop said, “Drugs don’t work in patients who don’t take them.”
When people fail to take the medications that have been prescribed for them, emergency room visits increase, hospitalizations increase, and people unnecessarily die. With such serious consequences possible, why would people ever skip taking their medication? There are multiple reasons. Let’s break them down into two categories: unintentional and intentional.
Unintentional reasons are the easiest to fix.
Forgetting. If you forget to take your medication, use an alarm clock or set a reminder on your smartphone to alert you it’s time to take your pills. Using a pillbox also helps and there are lots of varieties depending on your needs. Ask your provider to prescribe your medications in a way that you can take them all at the same time or close together, if possible. If there are medications that can’t be taken together, ask how far apart the doses need to be. If you leave the house frequently, keep an extra day of medications with you. That way, if you forget to take them before you leave home, you have them with you and can take them when you remember.
Confusion can be another barrier. If you don’t understand how to take your medications properly, schedule an appointment with your provider or the nursing staff to review them with you. Your pharmacist can also help with this issue. If you can’t get to your provider’s office easily, ask your provider to schedule a home health nurse to come to your home and review your medication with you. If you work and your schedule makes adherence difficult, talk to your provider. There might be medication or doses that would be better for you.
Intentional reasons to miss medications require more conversations.
People stop taking or miss doses because of mistrust, issues with side effects, cost, fear, or lack of desire or belief in benefit. Whatever your reason, your best bet is to discuss any of these issues with your provider. They can’t help you if they don’t know your concerns. Also make sure you tell your provider about any over the counter or herbal/alternative medications you take, as there can sometimes be serious interactions between these and prescription medications.
If you’re considering stopping a prescribed medication, I encourage you to talk to your provider about it first. That medication may be more valuable to your health than you realize.
If out-of-pocket cost or the inconvenience of going to the pharmacy every month is a contributing issue for you, ask your provider to prescribe your chronic medications in 90-day supplies. You’ll pay two copays instead of three, and you’ll only have to pick up your prescriptions (or receive the mail order) every three months.
Beth G Hodges, MD
Dr. Beth Hodges is a family practice and palliative care/hospice physician in Asheboro, N.C., as well as a part-time medical director for HealthTeam Advantage.