Taking medication when you need it is an important part of protecting your health and managing chronic conditions. Medication adherence statistics, however, are sobering. Studies show that around 20% to 30% of prescriptions are never filled, and approximately 50% of medications for chronic disease are not taken as prescribed.
That can be dangerous. Failure to follow medication regimens is estimated to cause approximately 125,000 deaths each year and is responsible for at least 10% of hospital admissions in the United States. In addition, it puts a big strain on the healthcare system, costing between $100 and $289 billion annually. So, what does medication adherence really mean? Why is it important? And how can patients ensure they are taking their Rx as they should?
What is medication adherence?
Medication adherence and compliance are two terms used to describe the extent to which patients refill their medication on time, take their medication as prescribed, as well as whether or not they continue to take a prescribed medication. There are many factors that contribute to medication adherence and compliance, such as remembering to fill a prescription, taking a medication at the right time, and remembering to follow all instructions regarding the medication.
“A patient is considered adherent if they take 80% of their prescribed medicine(s),” according to the American Medical Association. Taking any less than 80% of your medication means you are nonadherent.
For long-term therapies, the World Health Organization defines patient adherence as not only adhering to medication therapy, but also making diet and lifestyle changes per the recommendations of a healthcare provider. For example, blood pressure control often requires more than taking an antihypertensive. It requires eating a heart healthy diet, regular exercise, and stress management.
Why patients don’t take their medication
The reasons behind medication nonadherence can be multifaceted. “Many patients have hidden reasons they are not adherent to their medications,” says Ashley Roxanne, DO, a resident physician in Atlanta.
The cost of medications can also be a big hurdle. “For a patient on fixed income or working a minimum wage job,” Dr. Roxanne says, “sometimes the choice comes down to ‘Do I pay my electricity bill or do I get my prescriptions this week?’”
Another issue affecting medication adherence may be a patient’s lack of trust that a medication will be helpful for them, especially if the benefits are not initially apparent.
“For many chronic diseases, medications don’t necessarily make patients feel any better,” says Aaron Emmel, Pharm.D., founder and program director of Pharmacy Tech Scholar. “A great example is the statin medications: for those at risk, they can reduce the risk of a heart attack or a stroke. But this isn’t something that the patient feels, and they may even be experiencing side effects that are bothersome. This can make it hard to stay motivated to continue taking the medication.”
The reasons behind a patient choosing not to fill a prescription or take it as prescribed may be complex, but they don’t mitigate the consequences.
Why is medication adherence important?
The consequences of poor medication adherence can be dire, and may include:
- Disease progression: Disease progression refers to the way an illness affects a patient from the early stages, to its peak, and finally to its resolution. “Many chronic illnesses are progressive, and medications may be available to slow that progression,” says Dr. Emmel. However, as many as 1 in 3 patients with a long-term health condition never initiate a newly prescribed medication, according to adherence rates published in The Pharmaceutical Journal. If an illness is not treated, the progression can not be slowed.
- Risk of life-threatening complications: “Some of the consequences—depending on the chronic illness—can include a higher risk of suffering a life-threatening complication,” Dr. Emmel warns. Dr. Roxanne agrees and offers this scenario as an example: “Many patients with high blood pressure present to the emergency room nationwide every day with end organ damage that is often caused by their blood pressure being high from not taking their medications.”
- More ER and hospital visits: Medication non-compliance can lead to trips to the emergency room and hospital visits, as well as avoidable healthcare costs.
The good news is that these consequences can be avoided with good medication adherence, but what does that look like?
How to improve your medication adherence
Medications are only helpful if you remember to fill them and take them as prescribed. Fortunately, there are some simple tips that can help you do just that.
Address any and all medication concerns with your healthcare provider
“My biggest recommendation for increasing medication adherence is to maintain an open dialogue with your healthcare provider,” Dr. Emmel advises. “Make sure that you are getting all of the information you need regarding your health conditions and the treatments that are being offered. If you have any concerns, or any barriers to accessing a medication, inform your provider.”
Trust between healthcare professionals and patients is crucial. When you’re honest with your healthcare provider about why you’re not taking your medication, your physician can work with you to find a solution. For example, if cost is a barrier, your doctor or pharmacist might be able to suggest a lower cost alternative. Or, you can always search for a SingleCare coupon to save on your prescriptions. When you work closely with your healthcare team, it leads to better patient care and health outcomes.
Take steps to communicate clearly
To help you communicate with your healthcare provider, the National Institutes of Health recommends you:
- Write down a list of questions/concerns before your appointment
- Bring a close friend, caretaker, or family member with you to your appointment
- Take notes (or have a your companion take notes) during your appointment about what the doctor says
- Learn how to access your medical records, so you can keep track of important information
- Take time to understand your insurance coverage to avoid unexpected copayments on doctor’s visits and prescription refills
- Ask for the doctor’s contact information and their preferred method of communication in case you have follow-up questions
- Remember that nurses and pharmacists are also good sources for patient education
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Incorporate medication in your routine
It’s also a good idea to make your treatment regimen a regular part of your routine. That means linking a medication dose to something you do daily, like brushing your teeth. If it’s still hard to remember, use a mobile phone app or alarm to alert you when it’s time to take your medication.
Medication adherence is a complicated problem, but taking some simple steps can help to improve poor adherence and patient outcomes.