A spoonful of sugar helps the medicine go down. Unfortunately, getting patients to take prescribed medications often requires much more. Even though following medication directives is undisputedly beneficial for a patient’s health–as well as for the healthcare industry’s overall financial well-being–a surprisingly low number of patients take medications as ordered.
In fact, about 25 percent of prescriptions are never filled. And when patients do pick up their prescriptions, they don’t take them exactly as instructed about 50 percent of the time.
The big question: How can we get patients more engaged in their care and ultimately encourage them to consistently take their medications exactly as directed? To start, I believe the industry needs to continue to emphasize the patient’s role in their own care, calling specific attention to the medication adherence challenge.
To move in the right direction, we need to go beyond simple compliance and set our sights on adherence, which includes not only getting patients to take their medications exactly as instructed but truly engaging them in their medication regimens. With such adherence, patients fully understand the proper use of medications and potential side effects as well as what steps to take if doses are missed.
The good news: There’s plenty of motivation to embrace this approach. To start, by taking medications as instructed, patients can maintain better health. For example, asthma patients who properly use control medications are more likely to spend increased time at home and less time in the emergency room compared to patients who do not take preventive drugs consistently. Patients who use medications properly don’t need to see their physicians as often. In addition, when patients take medications as directed and respond appropriately to side effects, the number of adverse drug events is apt to decline.
All of this reduces costs. In fact, the healthcare industry could avoid between $100 and $300 billion in costs by improving medication adherence, according to statistics cited in a 2014 article published in the Journal of Risk Management and Healthcare Policy.
Medication adherence is not as easy as it looks. Successful adherence requires getting patients engaged in their care on both a conceptual and practical level. They must understand why they are taking the medications, and then they must follow through on this understanding.
However, in addition to the bad taste hurdle (which Mary Poppins famously overcame with some sugar and modern day pharmacists routinely address with flavor enhancers), the following barriers often get in the way:
- Urban myths that falsely perpetuate notions that specific medications do more harm than good.
- Cultural biases that steer some populations away from certain medications (for example, it might not be considered “macho” to take a medication in some cultures).
- Difficulties with medication synchronization, making it difficult for patients with multiple prescriptions to stay on top of refill schedules.
- Asymptomatic diseases, such as high blood pressure, which make it possible for patients to skip their medications without feeling any pain or discomfort.
To overcome these barriers, we need to look for ways to make it easier for patients to understand the importance of medication adherence. Healthcare professionals should provide both the counseling that will get patients on board, and specific written instructions that can guide patients to take their medications as directed.
The problem: One in three Americans struggles to make sense of such instructions, often due to literacy or language challenges. Thus, 1.5 billion prescription instructions are not understood each year. To address this challenge, pharmacies should provide patients with clear medication directives that:
- include intuitive representations of the amounts of medicine to be taken at times of the day
- provide pictograms designed to help reduce dosing errors
- provide easy-to-read instructions in a variety of languages
Providing this user-friendly education is just a start. The healthcare industry should also enhance medication adherence by making it easier for patients to implement instructions. Various online and mobile technologies and applications could help. For example, smart phone apps could remind patients when it is time to take a medication; alert patients when refills are needed; and even synchronize patients’ multiple medication orders, making it more convenient to obtain needed refills.
With these interventions in place, we can get patients engaged in their health and make it easier for them to understand the importance of following doctor’s orders and adhere to their medication regimen day after day.
About Nick Ratto, PharmD
Nicholas Ratto is the manager of FDB’s Consumer Drug Information group, responsible for the development and updating of all consumer-facing content including consumer medication information monographs, counseling messages, auxiliary prescription label warnings, and the High-Risk Medication Module. Connect with Nick on LinkedIn.