Tough Pill to Swallow
Modern medicines can be wonderful therapies -- if you remember to take them and take them properly. That may sound simple, but I've noticed that following a medication routine can be one of the great challenges for patient and physician alike.
Research suggests that half of all patients do not take their medicine properly. Missed doses, known as non-compliance or non-adherence, can worsen an underlying medical condition, lead to other health problems, or even prompt premature death. Skipping blood pressure medicine can lead to a heart attack; missed doses of glaucoma medication can speed blindness; intermittent or inaccurate insulin doses can result in diabetic emergencies. It's also a huge waste of money to buy pills and not take them.
There are myriad reasons for medication non-adherence.
It can be hard enough to remember to take a certain pill at a certain time of day for a certain length of time. Now imagine folks who have to take several pills a day -- and maybe some are prescribed for once a day and others are three times daily. It can get very confusing.
Some patients have poor eyesight and misread labels; others can't afford the medicine. For some, the act of taking a pill is an unwelcome reminder of being ill.
Many of us stop taking medicine when we start feeling better. This is especially true -- and especially risky -- for patients with high cholesterol or high blood pressure. Just because your blood pressure comes down doesn't mean it's a good idea to stop taking the medicine. That can lead to the heart attack or stroke the medication was intended to prevent.
Another reason for skipping doses is the side effects that patients attribute to a new medication. The drug mayor may not be the reason. The best approach is to it with your doctor, who can help determine if the drug is causing the problem, and if so, how to mitigate the side effects.
Ultimately, it's up to the patient to follow a drug regimen. But doctors must do their part too -- when they first prescribe a medication and throughout treatment. Research indicates that too often a physician does not clearly explain the reason for prescribing a particular therapy or dosage, let alone provide guidance on how to take it.
Doctors should follow up with patients, making sure prescriptions are refilled and the patient is comfortable with the regimen. Printed instructions or even a reminder phone call from a nurse are worthwhile.
Some tips for patients:
- Most important, check with your doctor if you are confused or want to make a change.
- Understand the purpose of each drug, the correct dose and possible side effects.
- Create a calendar to record when each medicine is taken.
- Post reminders on the refrigerator or medicine cabinet.
- Integrate medications into daily routines, perhaps with a certain meal or television program every day.
Technology -- some quite simple and others more sophisticated -- can also help. One of the most common and most successful tools is the pill box with separate compartments for each day of the week.
The federal Agency for Healthcare Research and Quality has developed an easy-to-use pill card that keeps track of what drugs are taken and when. It has colorful, common-sense symbols such as a rising sun for morning meds and a bag of sugar for diabetes checks. This link includes step-by-step instructions. http://www.ahrq.gov/qual/pillcard/pillcard.htm Family and friends might consider setting up cards for loved ones who aren't comfortable with a computer.
More elaborate devices are also on the market today, including pill boxes that sound an alarm when it's time to take the medicine and cell phone programs that flash reminders.
And some pharmaceutical companies are working on combination therapies that would enable patients to take a single pill for a host of maladies. That sure would make life easier!
Related Links:
Comments