Medication Adherence (Or Lack Thereof) Is a Big Problem

Americans are living longer, healthier lives, thanks in part to modern pharmaceuticals. Diseases that used to kill people in their 50s and 60s, such as heart disease, high blood pressure, diabetes and certain cancers, are now manageable conditions that we live with for decades…as long as we take our prescription medications.

Medication Adherence (Or Lack Thereof) Is a Big Problem

But not everyone takes their prescription medications exactly the way they’re supposed to. We skip doses, forget to take them or simply never get our prescriptions filled. In fact, the World Health Organization reports that a whopping 50% of patients don’t take their prescription drugs as prescribed.

So what happens when we don’t take our prescription medications? That depends on the medication and the condition you’re treating. With some medications, like over-the-counter analgesics prescribed for headaches, skipping a dose may do nothing worse than prolong your pain. However, skipping other medications — like those that manage diabetes, heart disease or blood pressure — could land you in the hospital (or worse).

For prescription drugs like antidepressants, hormone replacement medications and many others, skipping or missing doses may mean the medication can’t work as well as it is intended to. Many long-term medications depend on stable dosing in order to do their job effectively.

So Why Aren’t We Taking Our Prescription Drugs?

Part of the answer is because older adults are being prescribed more medications than at any time in history, and there are just too many for them to pay for and keep track of. Between 1988 and 1994, 38% of Americans were prescribed at least one drug. Between 2007 and 2010, that number increased to 49%, and the percentage of adults taking three or more prescription medications more than doubled.

In a survey of 10,000 patients, respondents gave five reasons for a lack of medication adherence:

1. They just plain forgot.

Twenty four percent of survey respondents said they missed medications because they were forgetful.

2. They don’t like the side effects.

In the same survey, 20% said the side effects made them quit taking their drug.

3. Prescription drug prices are too expensive.

Another 17% of survey respondents said that high medication costs made their prescriptions unaffordable. High prescription drugs prices cause some older patients to stretch their prescription dollars by taking less medication or fewer doses than prescribed, limiting the drug’s effectiveness.

Elizabeth Eckstrom, MD, Director of Geriatrics at Oregon Health & Science University agrees. “For many patients, the cost of medications present the biggest problem. Medicare Part D has helped bring down prescription drug costs for many older adults but still, too many drugs are way too expensive.”

4. They don’t think it will work.

Fourteen percent of respondents said they didn’t fill a prescription because they didn’t think it would do any good. Eckstrom says that’s because patients often don’t understand what the drug is for or why it’s necessary. “Doctors often don’t spend enough time talking with patients about medications,” she explained. “They may not tell them which prescription medications are the most important, how they work and about potential side effects.

5. Their impairments and age get in the way.

Many patients have age-related physical, cognitive or visual impairments that make it hard for them to get to a pharmacy, and can mean they misread prescription labels or misunderstand their doctor’s or pharmacist’s instructions.

This is a particular problem for adults who take multiple prescription medications or are managing multiple conditions. It’s also harder for older patients to keep track of prescriptions. Research shows that adults 80 and older are 1.5 to 3 times more likely to need help taking medications than adults 65–69, and men are 1.5 to 2 times more likely to need help than women.

4 Tips to Help You Take Your Medications As Prescribed

Whether you’re managing your prescription medications by yourself or managing them for someone else, you’ll up the odds of taking them correctly if you:

1. Use a weekly prescription medication organizer.

Pill boxes are a simple, but effective solution. Ask someone to double check that it’s set up correctly and that you’re using it regularly. (Everybody makes mistakes.)

2. Download a pill reminder app.

Push notifications, text messages and email reminders are a great way to help stay on top of your prescription medication requirements. (Especially, if you’re forgetful.)

3. Take advantage of auto-refill services.

Sign up for prescription auto-refill and delivery services so you never run out. CVS pharmacy and other pharmacies offer this helpful service.

4. Review your prescriptions regularly.

Talk to your pharmacist and your physician about which drugs are critical, and which ones you may no longer need. Also, ask your pharmacist to review your prescription each time you refill it and talk to your doctor about generic drug options if prescription drug prices are unaffordable.

About the Writer

Jeanne Faulkner

Jeanne is an RN with 25 years' experience working in women's health. Based in Portland, OR, she's the author of Common Sense Pregnancy and writes about health and wellness for a variety of publications and websites. As a CARE chairperson for advocacy, she’s traveled worldwide to raise awareness of poverty eradication and global health issues.

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