It’s important to take your medication as your doctor prescribed since it will likely give you the best chance of feeling better. However, for a number of reasons, many patients find it hard to properly follow medication regimens. In fact, it’s so hard that over 50% of US adults don’t take their medication as prescribed. This post provides tips that will make it easier for you to take your medication as prescribed.
How important is it to take medication as prescribed?
Very important!
Medication non-compliance, such as skipping or delaying a medication, or taking the wrong dosage, leads to an estimated 125,000 deaths in the US each year. And it’s responsible for up to 25% of all hospitalizations.
Unsurprisingly, patients are more likely to take their medications as prescribed when they have diseases with a greater perceived risk to their health, such as cancer and HIV.
Conversely, patients with chronic conditions (e.g., asthma, hypertension, chronic obstructive pulmonary disease, and diabetes) are less likely to take their medications as prescribed. This is unfortunate, and scary, because chronic health conditions are the main cause of death and disability in the world.
In fact, experts state that taking medication as prescribed (known as “medication adherence”) is a key determinant of outcomes for patients with chronic illnesses. Yet many patients find it hard to take their medications as prescribed.
For instance, studies show the majority of patients with chronic diseases either take less medication than prescribed, or stop the medication completely, after 6 months.
And in a small study of 188 patients with chronic obstructive pulmonary disease (COPD), only 58% took their medications as prescribed.
Furthermore, in a study of over 15,000 adults with diabetes, 19.5% didn’t continuously use their glucose-lowering medication, which is critical for reducing the risks of complications from diabetes.
Additionally, among those who also needed blood pressure medications, 17% failed to continuously take their blood pressure medications. Moreover, for those needing cholesterol medication, 43% did not take continuously take their cholesterol medications.
Why don’t people take their medication as prescribed?
Many issues can make it hard for people to take their medications as their doctor prescribed – both intentionally and unintentionally.
Here are some common reasons people don’t take their medication as prescribed:
- Not understanding when and how to take a medication, sometimes worsened by difficulties communicating with doctors and other healthcare professionals*.
- Getting the wrong medication at the pharmacy.
- Complicated medication routines which require taking different medications at different times throughout the day.
- Forgetting to take a medication, or taking too much of a medication due to forgetting it’s already been taken.
- Independently deciding to stop a medication.
- Concerns over potential side effects, or discomfort cause by side effects.
- Financial concerns.
*Note: For ease of reading, I use the term “doctor” throughout this post. However, I am referring to all healthcare providers, including doctors, nurse practitioners, nurses, and pharmacists.
Read below for information on each of these issues, along with tips to help you take your medication as prescribed.
1. Ask the right questions when getting new medications.
When doctors prescribe a new medication, it’s important to ask questions about why, how and when to take each medication.
Importantly, don’t rely on the medication label to provide you with important information. Research shows that up to 50% of patients don’t understand instructions written on prescription bottles.
Why are medication labels hard to understand? Problems can arise from several issues, including:
- Small print that is difficult to read.
- Vague instructions.
- Unfamiliar terms.
To avoid any confusion about your medications, ask your doctor these questions when getting a new medication:
- When should I take this medication, specifically? For example, does 3 times/day mean at meals or every 8 hours?
- How should I take this medication? With or without food?
- Any particular food or beverages to avoid while taking this medication?
- How long will it take to work? How will I know if it is working?
- What side effects should I watch out for? What should I do if they occur?
- Can I crush pills? Split pills?
- What to do if I miss a dose?
- How should I store it?
Importantly, be realistic about your ability, or willingness, to follow your doctor’s medication recommendations. Make sure you share any concerns with your doctor. For instance, if you expect that the side effects may keep you from taking a medication, say so.
Don’t feel intimidated by your doctors.
It’s easy to feel intimidated by doctors, especially if your doctor isn’t friendly and/or ignores your input or questions.
Generally speaking, doctors are very well educated and successful. But don’t let that make you uncomfortable. Most doctors are nice people who care about their patients. Of course, there are some doctors who intimidate patients by speaking rudely, rushing patients, or acting in other unpleasant ways.
I urge you to overcome your fears and ask any questions you need to understand your medications (and other medical questions as well). If shyness or intimidation holds you back, take a deep breath and ask your questions. And don’t be afraid to speak up if something doesn’t seem right. Be polite but persistent.
However, if a doctor is consistently rude and dismissive, it’s likely time to look for other options.
Don’t let language barriers get in your way.
Certainly, if you don’t fluently speak the same language as your doctor, it is hard to understand the information discussed. Therefore, I strongly recommend you either bring someone with you who can translate, or ask your doctor to provide a translation service.
2. Make sure you get the correct prescription at the pharmacy.
Unfortunately, studies show that up to 20% of prescriptions are filled with errors. This means that tens of millions, if not more, of prescriptions are not correct each year in the US. Most of the mistakes are relatively minor, but approximately 6% could potentially be harmful.
These errors include misreading the doctor’s prescription (many medications have similar sounding names), putting the wrong medication in the prescription container, or using a label with the wrong person’s name or wrong instructions.
Here are some suggestions to help you avoid these issues:
- When your doctor prescribes a medication, take a moment before leaving the doctor’s office to carefully write down the name and dosage of each medication – ask the doctor for correct spelling.
- Before you pay for the medication at the pharmacy, double check that you are getting the right medications. Keep in mind that correcting a mistake is much easier before you pay.
- If you get home and notice that a medication looks different than it previously appeared (change in color, shape or size), call the pharmacist to confirm the medication name and dosage before taking it.
3. Simplify complicated medication regimens.
Ask your doctor to help you make your medication regimen more manageable.
Firstly, ask your doctor if you can simplify your medication schedule by reducing the number of times you have to take medications each day.
Additionally, ask your doctor if you can switch any of your medications to long-acting drugs which have to be taken less often. And ask your doctor if any of your medications can be consolidated by switching to combination medications.
4. Use pill organizers and reminders to help you take your medication as prescribed.
When dealing with a serious medical condition, you not only feel under the weather, you are likely overwhelmed and stressed, making it harder to keep track of your medications. You may forget to take your medications, or take too a medication twice because you forgot you already took it!
Using organizer and reminders can make it easier to take your medication as prescribed.
Organize your medications.
It might seem impossible to imagine, but many patients struggle to remember if they have taken their pills on any given day. Using pill organizers – the simple plastic containers with daily compartments for your pills – can avoid this situation. If you’re not sure if you’ve taken your pills, simply look to see if the pills remain in the day’s compartment.
Beware that many pills look similar to others! To make sure you put the right pills in the right compartment, pick a consistent, quiet time each week to carefully sort your pills.
If you don’t want to use a pill organizer, you can get your medications in presorted prescription packs labeled with dose, date and time. With these packets, you just grab the right packet at the right time, and take each pill. You can get your medication this way through CVS or PillPack.
Of course, if you use liquids, aerosols, and/or injectable medications, pill organizers and presorted packets will not work.
Lastly, keep your pills in a location associated with your pill schedule. For instance, keep any pills you take with breakfast where you prepare or eat breakfast. But don’t keep pills in damp environments, like your bathroom. And make sure your medications are out of reach for children and pets.
Set up reminders.
In addition to organizing your pills, set up a system to remind yourself to take your pills at each needed time. Using your cell phone is an easy way to make sure you have a reminder with you at all times. You can either set alarms for the prescribed times, or you can use one of the many medication reminder apps available for smartphones.
If you have a complicated medication (or treatment) regimen that makes it hard to keep track, use the free ZaggoCare chart (upload here). After personalizing the chart to your daily needs, you can easily to see what you must do each day. By checking each task as it’s completed, you can quickly see what you’ve done already and what still remains undone. It’s easy to use and very helpful!
5. Don’t stop a medication on your own.
There are many reasons you might feel tempted to stop a medication on your own, including:
- Uncomfortable side effects.
- Thinking the medication has never helped you.
- Believing you no longer need a medication because you no longer have symptoms.
However, no matter why you want to stop taking a medication, speak to your doctor first. Importantly, realize that suddenly stopping some medications can cause you a great deal of harm.
6. Address concerns regarding side effects.
Unsurprisingly, there are two ways in which side effects can impact your willingness to take your medication as prescribed.
Firstly, you may choose to not even start a medication due to your concerns about potential side effects. Why? Perhaps you experienced side effects taking similar medications in the past. Or maybe you have heard about, or witnessed first hand, difficult side effects impacting other people taking the medication (or a similar medications) your doctor prescribed.
On the other hand, you may stop taking a medication because the side effects are uncomfortable and/or difficult to manage.
In both cases, talk to your doctor about your concerns. Your doctor can discuss the likelihood of each side effect, and what can minimize the side effects.
Additionally, you may find helpful information online from other patients regarding how to minimize side effects, although use common sense and discuss your findings with your doctor. For more information, read Can you Trust Medical Information Online? and Can you Trust Medical Information on Facebook?
Importantly, it’s possible a medication you need is going to be difficult to tolerate (such as chemotherapy). Realize the decision to take or stop a medication is up to you. If you don’t want to take a medication because of difficult side effects, that is your choice. But don’t make a decision without talking to your doctor – make sure you understand a medication’s benefits and drawbacks before deciding.
7. Don’t let money keep you from taking your medication as prescribed.
Medications can be very expensive, even with excellent insurance plans. It can be tempting to save money by only taking 1/2 pill at a time, or by skipping days, or even by not picking up the prescription in the first place.
Certainly, not taking the correct dosage can seriously impact your health. Fortunately, there are ways you can ease the financial burden of medications, as follows:
Talk to your doctor about money concerns.
Although doctors often don’t know how much medications cost, your doctor might be able to help you save money.
- First and foremost, tell your doctor you are struggling to pay for your medications. Although this can be an uncomfortable conversation, your doctor may suggest less expensive generics or alternative medications, or provide you with free samples or coupons for discounts.
- Ask your doctor if you can order a higher dosage pill that you could split in 1/2 before taking. Generally buying the higher dosage pill is not significantly more expensive than the lower dosage pill, allowing you to save money by getting two doses from each pill. If you split pills, be sure to use a pill splitter, a small inexpensive tool you can buy at the pharmacy.
Look into your coverage by your insurance plan.
Your insurance plan may be able to help you reduce the costs of your medication in several ways, as follows:
- If you receive insurance through your company, the Affordable Care Act, or Medicare, consider your medication needs when evaluating your options to see which plan will save you the most money.
- Find out if your insurance plan has negotiated discounts with a particular pharmacy chain, and if so, use the preferred pharmacy for all of your medications.
- Insurance companies have tiered lists of drugs they will cover. Generally the higher the premiums you pay, the higher the tier level covered. Check the tier level of a new medication on your insurance website or ask your doctor to check. If your plan will not cover a medication, ask your doctor if a “lower tier” medication can be substituted. If you or a family member take many expensive medications, a higher priced plan might save you money in the long run.
Look into programs offered by your insurer.
You insurer may have their own online pharmacy partners that can save you money, but it can take time to get your first order. You may save even more if you buy in bulk.
Use your Health Savings Account (HSA) or Flexible Savings Account (FSA).
If your employer offers either of these plans, take advantage of it and pay for your medications with pre-tax dollars.
Talk to your pharmacist.
Before you pay, ask your pharmacist is you are getting the cheapest price. Specifically ask about “all available” discounts and the “lowest cash price”.
And ask how much it would cost if you don’t go through your insurance plan. But realize the money you spend will not go towards your deductible or out-of-pocket maximum spending limit.
Shop around for the cheapest price in your area.
Not all pharmacies charge the same price for the same medication, so call pharmacies in your area. Be sure to have specific information for the medication, including dosage, and your insurance information. And ask about the lowest cash price without your insurance plan – it might be the cheapest way!
Additionally, you can use the website/app GoodRx to find prices (and discounts) for prescription drugs at local and mail order pharmacies in the US.
Buy in bulk.
Ask your doctor for a 90 day prescription which can save you a lot of money and be more convenient.
Buy medications online.
You can often save money by buying medications online, but sometimes seemingly authentic pharmacies are sham pharmacies selling old or counterfeit medications.
To minimize your risk of potentially dangerous problems, only use US-based online pharmacies that require legitimate prescriptions. Check legitimacy on the Safe Pharmacy website or visit BeSafeRx a registry of state-licensed online pharmacies.
And don’t be fooled by the sites that advertise “Canadian Pharmacy” – 85% of the time they are located in other countries, but advertise as Canadian to lure US buyers.
Use coupons and discount services.
You may find online coupons or rebates online by typing in the name of your medication and the word “discount” or “coupon”. Print them out and bring them with you to the pharmacy.
Additionally, try these discount prescription programs: FamilyWize, BlinkHealth, RxSaver, GoodRx, and NeedyMeds.org.
Seek help from organizations.
There are organizations that help patients pay for prescriptions. For a list of places that might be able to help you, visit Zaggo’s Resource Center page for financial help for prescriptions.
Seek help from the pharmaceutical company.
Many pharmaceutical companies have patient assistance programs. Search for the company’s website or look up medications and pharmaceutical companies on NeedyMeds.
Learn more by reading How to Save Money on Prescription Medications.
Learn more…
Certainly, it’s important to take your medication as prescribed. But there are other medication-related issues to learn about. Read these blog posts:
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