With the amount of medication that is prescribed to the elderly it is not surprising that many patients are overwhelmed, which can lead to nonadherence. Medication nonadherence is the practice of not taking medication as prescribed. Examples of nonadherence include taking the wrong dose, taking the dose at the wrong time, skipping a dose or stopping a medication before it is recommended to do so. According to the World Health Organization, 50% of patients with chronic diseases do not take their medications as prescribed, which generates over $290 billion in unnecessary medical expense. It is estimated that 10% of hospital admissions and 23% of nursing home admissions are due to nonadherence. More shockingly, approximately 125,000 people with treatable aliments die each year in the United States due to non-adherence. There are many reasons why people to not take their medications as prescribed. However, no matter the reason, with help from all members of the healthcare team, nonadherence can be overcome.
A common reason given for not taking a medication is forgetfulness. At least a quarter of people on a chronic medication report that they forget to take or refill their medications. To overcome this barrier, link taking a medication to an activity such as eating a meal or going to bed. Also, with the advent of technology, there are reminder apps that can be set on a smart phone or tablet. Some pharmacies will also blister pack medication so you can easily determine if you or a loved one took a specific medication each day. Your pharmacist can assist with blister packing or other solutions to combat non-adherence.
Another reason people say they do not take medication as prescribed is transportation challenges that present difficulty in picking up their medications at the pharmacy. Elderly patients and those with debilitating diseases often have the most trouble getting their medications due to their physical limitations or inability to drive. In these cases, patients should take advantage of delivery services offered by some pharmacies. Additionally, pharmacies may “sync” medications to be due at the same time, eliminating the hassle of multiple trips for refills.
Complex medication regimens often lead to nonadherence due to patients being overwhelmed by how and when to make multiple medications. It is important to review the directions for each medication with the doctor or pharmacist at each visit to understand the medications prescribed. Consultations with a doctor or pharmacist are a great time to discuss other options to simplify the medication regimen.
The cost of medications has skyrocketed in the last few years. This can lead patients to become non-adherent to their medication regimens due to financial limitations. There are some ways to control costs including asking if a generic alternative is available for your medication. Generic medications are often significantly cheaper than brand name but have the same pharmacologic effects. If no generic is available, drug manufacturers offer programs to help offset the cost through discount coupons or patient assistance programs. It may be as easy as going to their website to see if you qualify. It is imperative that you never cut pills or share medication as a way to save on the cost of your medications. Just because your neighbor takes medication for his cholesterol doesn’t mean that same medication can be used to treat your cholesterol.
The last barrier to overcome when discussing nonadherence is perception of need. Almost 60% of patients stop taking medication when they feel better. This is especially true with antibiotics. A quarter of patients report they stop taking medication because they did not notice an improvement in their health. Couldn’t it be said, “well my blood pressure doesn’t feel high today”? It is so important that even if someone does not feel unwell, the underlying disease still exists and medication to treat should not be discontinued abruptly.
Perhaps you can identify with one of these reasons for not being compliant with your medications. Be sure to talk to your healthcare team to come up with solutions work best for you and your lifestyle.
DISCLAIMER: The information contained in this article is intended solely for the general information for the reader and is not intended to be a substitute for professional medical advice, diagnose health problems or suggest any treatment. It is not a substitute for medical care provided by a licensed and qualified health professional and does not create a physician-patient or pharmacist-patient relationship. Please consult your health care provider for any personal medical advice