Minding Your Meds Blog
Overcoming non-adherence: Why it’s important to stick to medication regimens
Many issues facing medicine today concern ailments of which no cure yet exists. But while these patients and their loved ones suffer looking ahead to such uncertainty, there are those that take this blessing of a clear future for granted and choose not to conquer their illnesses despite the available means. This epidemic of non-adherence to medication therapy can be described as a war that medicine has already fought and succeeded through much expense and many years of study–yet sadly, one that is now a collective battle among the health care industry instead as patients neglect these advances. Statistics from a report conducted by The Center for Health Transformation in 2010 entitled, “The 21st Century Intelligent Pharmacy Project: The Importance of Medication Adherence,” reveals that approximately 342 people die every day due to non-adherence, and that the rate of patients not following their regimen–40%–and new prescriptions not being filled–20%–remains steady since the 1980s. Additionally, it is said that non-adherence accounts for nearly a quarter of hospital and nursing home admissions. And while the study suggests involving pharmacists in the development of a solution and “a multidisciplinary approach to understanding patient behavior,” the problem persists in making it one of the forefronts of health care issues today.
Prescriptions and Patterns
There are a number of diseases and illnesses that innovations in science and technology have found ways of either curing or substantially improving by carefully structured formulas. But those miracle formulas only work in a strict manner to compensate for the physical limitations of the human body. This specific design to each formula operates like a well-planned blueprint in order to allow the body to absorb and utilize the maximum amount of certain drugs at a given time that can cause harm in overdose. Deviation from the prescribed routine–such as taking one’s pills two days in a row and then forgetting the next three days–not only makes the benefits from the formula less effective, but constant irregularity can build a tolerance within the body to the necessary drug.
Think of our bodies when they were newborns. Babies generally follow a natural sleep and eating schedule because they’re constantly generating new cells for growth that thrive on pattern and routine–when they sleep, their brain knows it’s the time to build, and when they eat, their digestion gears up for the activity of processing nutrients to all the right places. All this stimuli creates a need for the baby to stick to a routine so that their body knows what to expect and the baby can focus on internalizing new experiences. As we grow and our bodies mature, those processes become learned and the necessity for routine becomes less of a priority for functioning. However, our body never loses the program for pattern since it did so much to help us in our early stages of development and often regulates itself by following its own set of duties according to what we’ve accustomed it to. That’s why when you start your new medication therapy it’s often planned out with clear instructions to follow because it takes advantage of your body’s natural inclination to familiarize, knowing what to do with the components of a given formula according to that formula’s blueprint. As the complexity and splendor of our bodies go unrecognized, patients are unaware of the inherent dangers non-adherence to their medication regimens can have, and often the consequences become too great before they even know that recovery is too late.
Why is non-adherence so prevalent?
As awareness is raised to this issue, which seems so simple in its solution, it’s important to explore the reasons for why people do not adhere to their medication. These can include an individual’s…
Alexandra Sifferlin of Time magazine published an article in 2015 entitled, “Americans Spent a Record Amount on Medicine in 2014.” In the article it is estimated that “Americans filled 4.3 billion prescriptions and doled out nearly $374 billion on medicine in 2014.” This added to the pressures of expenses that various insurance programs don’t cover makes it difficult for patients to account for prescriptions within their budget. For example, those insured through Medicare and suffering from Alzheimer’s disease spent nearly $70,000 over the last five years of their lives while those insured by the same and suffering from cardiovascular disease or diabetes spent near $40,000, according to article, “The High Cost of Out-of-Pocket Expenses” by Judith Graham, which appeared in a 2012 posting on the New York times blog. And according to an article by Adam Wenger in 2014 on healthline.com entitled, “The Cost of Treating HIV: One Man’s Monthly Medical Bill,” HIV treatment costs an average of nearly $400,000 over the course of a patient’s lifetime. One man, who takes four pills a day, spends over $3,000 monthly on medication alone. It’s these kinds of numbers that withhold patients from keeping up with mandatory prescription refills, and can cause them to do more damage to their health despite the availability of medication.
But adhering to your medication is easier when you have taken the time to reassess your budget and account for the extra expense for the duration of the treatment. For some, that means integrating adjustments on a long-term basis, and for others, it may be shorter.
Some of us have incredibly busy schedules that even the simplest of antibiotics or birth control pills seems impossible to keep up with. And it seems that the more attentiveness required to a regimen–taking two or more pills a day and at certain times–the more we tend to neglect that responsibility. This is especially true if we have obligations concerning people other than ourselves, we seem to put their importance over our own. And while this reflects nobly on our character, the old adage that one cannot be expected to take care of others until they’ve taken care of themselves still rings truth, especially when it comes to our health. Often times it’s a matter of being reminded–if we have to remind ourselves, the duty of taking the medication turns into an annoyance and we have a negative impression of medication therapy that sticks with us.
Digital reminders do more to help patients with this obstacle than pill dividers organizing one’s medication into days. It will be less of an annoyance if you are prepared with the medication at all times and have something to remind you of both taking the medication and leaving home with it in the first place.
Sometimes we don’t have an impossible schedule or budget to impede our adherence. Sometimes we simply have cultural differences in our attitudes about time and routine. For instance, in some families, deadlines and punctuality have just never mattered as much as other families who depend on that structure and order to live their lives contently by.
These patients too would benefit from a tool that gave them daily reminders in order to infiltrate those distinct behavioral differences that are so culturally influenced.
In addition to these factors there are those that don’t adhere to their regimens strictly out of a fear of the side-effects and feelings associated with a particular medication. There are no external resources to assist with this that science hasn’t already tried to combat, but knowing that the consequences can be worse than the avoidance of the medication can be used as a strong motivator. Antithetically, there are those that are prone to addiction and can end up abusing their prescriptions. But this often occurs if the individual has a propensity for it in which the doctor can account for this factor in their dosage and prescription strength. But another scenario that can lead to it in even those patients that don’t have addiction problems is one in which the patient misses a day and then takes the lapsed pills with her daily dosage much like is directed with the birth control hormone or antibiotic. But what people don’t know is that pills are so precise in their composition that missing a day often has greater consequences than a makeup day can really compensate for, sometimes even resulting in an overdose or higher dependence. That’s why a reminder can provide immensely valuable benefits to the efficacy of the treatment itself and your body’s own natural wiring and limitations.
These factors relating to medication therapy are all worthy of your consideration as a patient and an activist for your own health and vitality. Non-adherence to medication is one of the worst things you can do for your recovery process in any ailment. It’s only to your benefit in all areas of your life regarding emotional stability, practical concerns and your loved ones to gain awareness about the issue and take action.