When it comes to health care, the biggest downfall of most patients is failing to follow through on prescribed therapies. A recent study by Duke University Medical Center and the National Consumers League indicates that failing to take your medicine as prescribed leads to lower quality of life and significantly increased health care costs.
“Half of the 3.2 billion annual prescriptions dispensed in the United States are not taken as prescribed. Numerous studies have shown that patients with chronic conditions adhere only to 50-60 percent of medications as prescribed, despite evidence that medication therapy improves life expectancy and quality of life. . . . [I]t is estimated that for every additional dollar spent on adhering to a prescribed medication, medical costs would be reduced by $7.00 for people with diabetes; $5.10 for people with high cholesterol; and $3.98 for people with high blood pressure.”
—Medication Adherence: Making the Case for Increased Awareness, Co-authored by Hayden B. Bosworth, Ph.D., Duke University Medical Center and the National Consumers League
Why don’t we take our medicine? We have every excuse in the book at our disposal:
- I forgot/was too busy to fill the prescription.
- My insurance company requires me to fill the prescription in a time-consuming way that frustrates me (mail order, specialty pharmacy, etc.).
- The medicine was too expensive and I couldn’t afford it.
- I don’t think I really need this medicine.
- I don’t have enough time or energy to take this medication as scheduled.
- I don’t like the way I feel on this medicine.
- I started out taking the medicine as prescribed but I didn’t see a difference so I stopped.
- I started out taking the medicine as prescribed and felt better so I don’t need to take it anymore.
It’s a classic organization and motivation problem!
If we look back to what we learned about implementing change in March, we can apply those strategies to improving medication compliance.
Analytical/logical knowledge – Your doctor should have done a good job explaining to you why you need to take this medicine and how it is going to work. Researching your medicine on the Internet or talking to other people taking the medicine may also help convince you of its benefits.
Reflection/emotional processing – The biggest emotional stumbling block for most people when it comes to taking medication is that they have to admit that they are not superhuman and that they need help (from the medicine) to be strong and healthy. Some people never get over the fact that while they used to be able to get through life without their medication, they can’t do that now and expect the same results. They view the medication as a sign of weakness. Rethinking the medication as a tool toward power and strength rather than a reminder of weakness is key.
Make the path easier – Take whatever avenues you can to make taking your medicine easier.
Choose a workable schedule– Pick a time to take your medicine when you are already focusing on your health. At night when you are brushing your teeth is a natural time or maybe first thing in the morning. The biggest challenge is having to take medicine at regular intervals throughout the day. If you don’t eat meals at regular times or you are embarrassed to take medicine when eating with others, aiming to take your medicine with meals may be a losing strategy. If you are struggling to create a schedule that works for you, talk to your doctor about options for types of medication (chewable, liquid, pills, shots, etc.) or strength of medication (once a day versus several times).
Choose a convenient storage/dosage spot – While the bathroom medicine cabinet is the most common storage spot for medicine, it is generally acknowledged to be a bad place to store your medication as the humidity of the room can degrade the medication. Moving your medicine to another spot, however, can hinder your medication compliance. The bedroom dresser is my current medicine spot. To make it work, however, I have to store a large bottle of water there so I can take the medicine right away rather than forget to take the medicine while looking for a cup of water. (I use water from my emergency supply so I am also rotating our emergency stock and accomplishing two tasks at the same time.) With small children around, I also have to be careful that all the medicine is stored in child-proof containers.
Use organizational tools – Pill organizers are not just for old people. They help to keep track of how much medication you have left and also give you a visual reminder of when you have missed your dose. Fill it up at the end of each week or once a month as part of your regular routine.
Automate refills – Many pharmacies offer some sort of automated refill option you can sign up for. If you are prone to forgetting to refill, take advantage of this service.
Motivation – Once you leave the doctor’s office, you are responsible for making sure that you follow through on the instructions you have been given.
Document your progress – If you are struggling to take your medication, start writing down when you do (and don’t) take it. For me, this was very helpful in creating and sticking to a regimen for my daughter’s therapy. I was getting frustrated that things didn’t seem to be working and had to face reality that my non-compliance with the exact doctor’s instructions was part of the problem. Now that I am accountable to myself and have an objective measure of how I am doing, her therapy is going much better. You can create your own log with a simple spiral notebook and a pen or download or purchase specialized forms for your condition/medication.
Free downloadable forms:
*A variety of different types of medical log templates for Word and Excel from Microsoft Office
*More medication tracker forms of various kinds. Free to print with site registration.
Seek external motivators – Your doctor can be a motivator. Make sure you keep regular follow-up appointments and don’t cancel because you haven’t complied with your therapy. Go to your visit anyway and confess and promise to do better. Shaming can be motivating. There is a stern technician at my daughter’s doctor who will let us know exactly how we are failing her expectations when we don’t do everything as prescribed. While this could be discouraging and embarrassing to many people, we have chosen to make this a positive motivator and have a goal to make her proud of us at the next visit. If you can’t handle any sort of negative feedback, let your doctor know that you need positive encouragement only and seek a trusted friend or family member to be your medication cheerleader.
Forgiveness – If you miss a day, a week or a month, of your medicine, don’t tell yourself that you are a failure. Remember that everyone faces these same challenges and allow yourself some understanding. See every day as a day to start again.
Expecting failure/willingness to experiment – Doctors don’t always have time to help people figure out how to comply with their medication schedules. Here is where you need to come up with creative solutions for yourself. If you are failing to take your medicine, something is not working for you. Change it! Change your dosage scheduling. Try a pill organizer. Write down when you take the medicine or text a note to a friend you are accountable to. Keep trying to make it work. Also, if your doctor needs to experiment with different medicines until he or she finds what works for you, be patient. Do the very best you can with each therapy even if they end up being failures. Some medicines take time to work. Read, for example, Sammy’s mother’s dedication and patience in finding a therapy for her son’s OCD disorder.
Do you get frustrated with medication schedules? What tricks do you use to remember to take your medicine? Please share in the comments.