• Medication Non-Adherence and Chronic Conditions

    Image for arixtra Medication non-adherence is when you do not take a medicine as prescribed. Some examples of this include:
    • Not filling the prescription
    • Not getting refills
    • Taking a different dose than prescribed
    • Not taking the medicine as often as you should

    What Are the Consequences?

    Chronic conditions, like heart disease, cancer, stroke, and diabetes, are commonly treated with drug therapy. Unfortunately, statistics show that a low percentage of Americans with chronic conditions take their medicines as prescribed.
    This can result in serious consequences. For example, your condition could worsen, leading to more intense treatment, more medicines, and even hospitalization. Medication non-adherence can also be a financial burden since it may cause you to have more doctor appointments and more costly prescriptions. In extreme cases, not taking your medicine can lead to a heart attack, stroke, or even death.

    What Are the Reasons for Non-Adherence? What Can You Do?

    There are many reasons why people do not take their medicines. Here are some common reasons and ways to counter these concerns.

    I do not understand how to take the medicine.

    Make an appointment to talk to your doctor. Write down any questions you have. Make sure you are clear about:
    • The dose—How much medicine do you need to take at one time?
    • The daily schedule—How many times during the day do you need to take the medicine?
    • The duration—How long do you need to continue taking it?
    • Steps to take if you miss a dose—Do you need to take the medicine as soon as possible or should you wait until the next day?
    • Special instructions—For example, should you take the medicine with food?
    Your pharmacist is another resource. Ask him about your medicine, possible drug interactions, and side effects.

    I am afraid of the side effects.

    Your doctor can explain which side effects are common and what you should do if you have any problems. For example, if the medicine causes you to feel excitable, you may need to call your doctor right away. Knowing the potential side effects and how to handle them can help ease your fears.

    The medicine is too expensive.

    Before you decide not to take the medicine because it is too costly, explore your options:
    • Ask your doctor if she can prescribe a less expensive generic drug.
    • If you have prescription drug coverage, find out which drugs are covered under your plan.
    • Learn about patient assistance programs. If you are eligible, you may be able to get your medicine at a lower cost. You can find more information online or through your pharmacist.

    I feel fine. Why do I need to keep taking the medicine?

    Some conditions do not have symptoms that you notice. But that does not mean your health is fine! In other cases, the symptoms go away because of the medicine. So if you were to stop taking it, your symptoms would return.
    If you are not sure how the medicine works in your body or why you are taking it, talk to your doctor. It is important to understand the purpose of the medicine and what could happen if the condition goes untreated.

    It is hard to remember to take my medicine!

    There are a number of strategies to try:
    • If you take a lot of medicines, create a chart. List the names of the medicines, the dosages, and the time of day when you need to take them.
    • Have a set routine, like taking your medicine when you make coffee in the morning.
    • Use a pill organizer. This is a plastic container that has a section for each day of the week.
    • Use technology! There are many “pill reminder” products, like talking alarm clocks, watches, and timers that have a section to hold pills.
    • If you have to take a lot of medicines each day, talk to your doctor. She may be able to change your medicine regimen.
    If you are facing challenges when it comes to taking your medicine, get help from your doctor and pharmacist! The steps that you take now to care for your chronic condition can have a huge impact on the rest of your life.

    RESOURCES

    Educate Before You Medicate http://www.talkaboutrx.org/

    Script Your Future http://scriptyourfuture.org/

    Take Control of Your Health http://www.tcyh.org/

    CANADIAN RESOURCES

    Canadian Pharmacists Association http://www.pharmacists.ca/

    Health Canada http://www.hc-sc.gc.ca/

    References

    The 21st century intelligent pharmacy project: the importance of medication adherence. Center for Health Transformation website. Available at: http://www.healthtransformation.net/galleries/wp-HIT/White%20Paper%20on%20Medication%20Adherence.pdf. Published 2010. Accessed September 26, 2011.

    Bosworth H. Medication adherence: making the case for increased awareness. Script Your Future website. Available at: http://scriptyourfuture.org/wp-content/themes/cons/m/Script%5FYour%5FFuture%5FBriefing%5FPaper.pdf. Accessed September 26, 2011.

    Chronic diseases. Centers for Disease Control and Prevention website. Available at: http://www.cdc.gov/chronicdisease/resources/publications/AAG/chronic.htm. Updated December 17, 2009. Accessed September 26, 2011.

    Getting the most out of breast cancer treatment. Educate Before You Medicate website. Available at: http://www.talkaboutrx.org/documents/CSI%5FPatient%5FFact%5FSheet%5FHandout.pdf. Accessed September 26, 2011.

    Gray R, White J, Schulz M, Abderhalden C. Enhancing medication adherence in people with schizophrenia: an international programme of research. Academia.edu website. Available at: http://eastanglia.academia.edu/RichardGray/Papers/132177/Enahncing%5Fmedication%5Fadherence%5Fin%5Fpeople%5Fwith%5Fschizophrenia. Published 2010. Accessed September 26, 2011.

    The importance of drug compliance. The Cardiomyopathy Association website. Available at: http://www.cardiomyopathy.org/Importance-of-drug-compliance-in-cardiomyopathy. Accessed September 26, 2011.

    The importance of taking your medicine. Heart Failure Matters.org website. Available at: http://www.heartfailurematters.org/EN/WhatCanYourDoctorDo/Pages/2112.aspx. Accessed September 26, 2011.

    The importance of taking your medication correctly. Cancer.net website. Available at: http://www.cancer.net/patient/All+About+Cancer/Cancer.Net+Feature+Articles/Side+Effects/The+Importance+of+Taking+Your+Medication+Correctly. Updated June 25, 2010. Accessed September 26, 2011.

    National Council on Patient Information and Education. Enhancing prescription medicine adherence: a national action plan. Educate Before You Medicate website. Available at: http://www.talkaboutrx.org/documents/enhancing%5Fprescription%5Fmedicine%5Fadherence.pdf. Published August 2007. Accessed September 26, 2011.

    Osterber L, Blaschke T. Adherence to medication. National Consumers League website. Available at: http://www.nclnet.org/sosrx/membersonly/sept21/adherenceNEJM08042005.pdf. Published 2005. Accessed September 26, 2011.

    Take control of your medicines. Take Control of Your Health website. Available at: http://www.tcyh.org/medications/medications.shtml. Accessed September 26, 2011.

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