THE IMPORTANCE OF MEDICATION COMPLIANCE
Helping your loved one maintain a proper medication regimen
BY:ERIC FEIL
"Staying on a medication for a long period of time takes a lot of work," says Anne Burns, group director of practice development, the American Pharmacists Association (APhA). Yet that hard work on the part of both patients and caregivers is vital. As Burns points out, paraphrasing former U.S. Surgeon General C. Everett Koop, "A drug can't work if you're not taking it."
"Noncompliance is one of the biggest issues in healthcare today," says Katherine Binns, president of healthcare research, Harris Interactive. In fact, according to a 2005 Harris Interactive report, roughly half of all prescriptions for drugs to be taken on an ongoing basis are either not completed or are never filled in the first place. "There is a much greater focus now on finding out the reasons why people fail to take their medications," adds Binns, "particularly among seniors, with whom factors can range from cognitive issues to depression to physical problems."
"Drugs that treat asymptomatic conditions are the most likely not to be taken," says Burns. "Many people think, ‘If I don't feel any symptoms or don't see any tangible results, why should I take them?' This is particularly the case with conditions like high blood pressure or high cholesterol. Yet, in the long term, the effects of not taking these medications can be devastating."
"In some cases," Binns notes, "people can simply become overwhelmed by the number of different medications they're on." A report from the American Heart Association supports that assertion, noting that nearly 60 percent of patients taking five or more medications take them improperly.
Despite the magnitude of the problem, though, noncompliance is a battle that caregivers, healthcare providers and patients can fight together. "The first step is to identify the reasons why someone is not taking their medications," says Burns. "Then there are a number of options."
Leading Reasons for Medication Noncompliance
Forgetfulness/Wasn't reminded to take medication
Disbelief that drug is necessary or is helping
Fear of side effects
Experiencing actual side effects
Belief that medication would have a negative impact on performance of daily activities
Desire to save money
Felt symptoms had disappeared so drug was no longer necessary
Confused by instructions
Overwhelmed by number of drugs prescribed
Difficulty opening medication container
Difficulty swallowing medication
How a Caregiver Can Help
Set Daily Routines. "If it's a problem of remembering, try to link taking the medication with normal, recurring daily activities, like going to bed or eating meals," Burns offers. "The one caveat is that the routines must be appropriate. Some medications can't be taken together, some can't be taken with food, and so on. It's very important that the patient or caregiver talks to a pharmacist or physician about whether or not any of those issues apply with their medication therapy."
Use Packaging Aids. These are particularly useful for patients taking multiple medications. Along with plastic daily-dosing containers available at pharmacies, some pharmacies offer a service in which a patient's medications are assessed and then divided into individualized packages marked for particular doses at specific times. "Those types of packaging aids can be very effective," says Burns, "since it's not only about remembering to take the medication, but later remembering if you took it."
Try Reminder Services. Along with programs in which pharmacies fax reminder alerts to doctors when a patient fails to refill a prescription after a certain amount of time following the date their previous prescription ran out, "you can also contract with companies that call and remind you to take your medication," Burns offers. To connect to a free service offering email alerts, click here.
Ask Questions. "Understanding why you're taking a medication can help," Burns says. "Always ask doctors or pharmacists for clear, precise explanations and instructions regarding medications. If you don't understand any aspect of what they're saying, ask for more clarification."