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Many Americans struggle with sticking to their medication schedule. Fortunately, there are resources and strategies to help patients stick to a medication schedule and to improve medication adherence.
Medication adherence is the process of fulfilling a prescription, taking it as recommended, and stopping when it’s no longer needed. Those who practice medication adherence often experience better health outcomes.
Medication adherence helps people overcome health concerns and manage symptoms of acute and chronic conditions, yet many of us struggle with taking medications as prescribed. When someone doesn’t take a medication or follow a prescription’s instructions, also known as non-adherence, the likelihood of hospital admissions, worsening symptoms, and higher healthcare costs in the future is increased.
To improve medication adherence, there are some strategies to try and free resources to make it easier to take medications as prescribed.
What is Medication Adherence?
The World Health Organization (WHO) defines adherence in healthcare as, “the degree to which the person’s behavior corresponds with the recommendations from a healthcare provider.” When it comes to medication specifically, that means a patient takes a prescribed medication correctly.
Medication adherence includes:
Initiating medication when prescribed
Taking the medication at the recommended frequency (whether daily, twice a day, weekly, or on another cadence)
Following any other instructions for the medication, such as refrigerating it or taking it after a meal
Discontinuing when medication is no longer needed
What is Medication Nonadherence?
Medication nonadherence can take many forms, such as missing a pill or skipping prescription refills. It also applies to any errors that hinder someone from taking medications correctly. Examples of nonadherence include when someone doesn’t refill prescriptions, takes a medication incorrectly, stops taking the medication before its recommended date, or doesn’t discontinue when it’s no longer needed. Nonadherence can be harmful to a person’s health and can lead to treatment failures, especially for those with chronic conditions.
Reasons for Nonadherence
Some studies suggest that 50% of patients don’t take their medications as prescribed, making medication nonadherence about as common as medication adherence.
The reasons for nonadherence are varied. Some of the most common include:
Mental health and cognitive impairments that are out of a patient’s control
Painful side effects of a medication, such as headaches, diarrhea, and nausea
High prescription costs
A lack of clarity around dosage, frequency, or timing
Mistrust of a healthcare provider, a poor relationship with the prescribing doctor, or improper patient care
Limited access to the medication because the patient doesn’t live near a pharmacy or cannot have the medication delivered to their home
Forgetting to take medication due to life circumstances, such as frequent travel for work or not having a routine for medication adherence
While these reasons are valid, it’s up to patients, the healthcare system, and individual healthcare providers to collaborate and find solutions for improved medication nonadherence. If you’re struggling with an adverse drug reaction or are confused about the dosage requirements, always contact your doctor or speak with the pharmacist.
Seven Ways to Stick to a Medication Regimen
Medication adherence can be tricky to implement, but it’s not impossible. To help, we’ve compiled a list of the seven most effective medication adherence tips. These strategies focus on what people can do to overcome barriers to medication adherence, including how to access free resources to lower medication costs or get clarity on how to take a medication.
Get a Pill Organizer
If the question, “Have I taken my medication today?” pops up often, it might be time to invest in a weekly pill organizer. A weekly pill organizer has a slot for each day of the week and can be an effective tool for a patient’s treatment regimen.
The user inserts prescribed medications in each daily pillbox. If they take multiple pills, they insert all they take on a given day. When Tuesday comes, they take the pills in Tuesday’s box, on Wednesday, they take the ones in Wednesday’s box, and so on.
There are also automatic pill dispensers for those who prefer a more advanced solution. These hold seven to 28 days’ worth of pills and dispense pills automatically up to four times a day. If someone has a pill they take multiple times per day, especially if it’s for a chronic disease, cardiovascular disease, or other serious condition, the pill dispenser may be a better solution. It’s also a better form of medication therapy management for those who take multiple medications throughout the day.
Explore Cost-Effective Options
High medication costs may lead someone to not fulfill their prescription. If they do fulfill the medications prescribed to them, they may ration the medication due to the fear and financial stress of paying for the next fulfillment. Overcoming costs is a burden for patients and physicians to tackle together.
Healthcare professionals should ensure a medication is covered by a patient’s insurance before they prescribe it. If a physician does prescribe a medication that isn’t covered, there are some resources to find affordable places to buy the medication, such as GoodRx and the Medicare.gov drug availability database. Not to mention, switching to a generic brand drug or participating in online pharmacy orders could also help cut medication costs.
Note: For more information on lowering medication costs, visit this source.
Maintain a Schedule
If a patient has high blood pressure or a chronic illness, a healthcare provider will create a treatment plan that minimizes risk factors and adverse outcomes. Similarly, patients should create a schedule for taking their prescribed medicine.
Routines with higher patient adherence rates often include:
Taking medications after a specific activity, such as brushing teeth or eating dinner
Setting a timer or reminder on an electronic device to eliminate adherence barriers
Place medication in visible spots to avoid “out of sight, out of mind”
If someone has trouble taking medications on their own, a home health aid or assisted living program where nurses administer medications may be necessary.
Ask for a Longer Supply
For those who live in rural areas or don’t have a car, getting to community pharmacies to refill prescriptions is a monthly challenge. If struggling with this barrier, ask a healthcare provider for a longer prescription, such as a 90-day one. With a longer prescription, a patient must go to the pharmacy less often, allowing those who live far away to achieve medication adherence easier.
Alternatively, there are mail-order prescription services. Medicare has an entire page detailing how mail order prescriptions work and eligibility requirements.
Find a Provider You Trust
An underexplored barrier to medication adherence is the patient-physician relationship. In a 2018 study, over 80% of patients experienced improved medication adherence in a California healthcare office after the practice invested time and resources into cultivating better physician-patient relationships and patient education.
Educating a patient about how to improve patient compliance and the dangers of patient noncompliance is the responsibility of a healthcare provider, not a patient.
Yet as a patient, there are a few ways to cultivate a better relationship with a healthcare provider:
Prepare for a doctor’s appointment: to learn more, check out these six ways to prepare for a doctor’s appointment.
Ask for clarity: When medication instructions are unclear, call a doctor or schedule an appointment to discuss how to take a certain medication. This is especially important for medications with complex dosing regimens.
Ask questions: don’t be afraid to speak up if something is confusing. These 100 questions to ask a healthcare provider can provide talking points if unsure of what to discuss in an upcoming appointment.
Find a new healthcare provider: if all else fails, begin the search for a new healthcare provider. Ask questions about how they view patient involvement in the healthcare process, general patient outcomes they often expect, and their initiatives to educate patients on creating a drug regimen.
Read Medication Labels
Reading the medication label often provides quick answers to patients’ medication questions. The U.S. Food and Drug Administration provides more guidance on what different sections of a drug label mean. However, most drug labels provide the following information or instructions:
Dosage and administration information
Warnings and side effects
Any possible drug interactions
Instructions on use for specific populations, such as for pediatric or pregnant patients
When exploring a drug label, jot down any notes about the medication. For example, if a medication needs to be refrigerated or shouldn’t be taken on an empty stomach, write it down so it’s easier to remember.
Track Medication Use
Keeping a list of medications is a good idea. Tracking when someone takes each medication is an even better one. There are a couple of ways to track medication use, including the use of paper medication calendars or downloading a medication tracking app, such as MyTherapy or MediSafe.
Know When to Stop
This may appear contradictory, but knowing when to stop taking a medication is as important as knowing when to take it. If someone fails to stop a medication, they could develop a drug addiction or experience adverse health effects, such as developing a different health condition or developing resistance to the prescribed medication.
Note: If you’re struggling to stop taking a medication or have concerns about the possibility of a drug addiction, contact the Substance Abuse and Mental Health Helpline at 1–800-622‑4357 (HELP).
Enroll in Medicare Refill Reminder Calls
Often, a pharmacy practice offers medication refill reminder calls. People enrolled in these calls either get an automated call before they are due for a refill or if they are late to refill a prescription. Medication adherence among patients enrolled in these calls is often higher.
To enroll in this service, ask a pharmacist about it when picking up the next prescription.
Dangers of Poor Medication Adherence
Skipping a pill on vacation or during a busy day may seem harmless. But when someone consistently forgets to take their medication, it has negative impacts.
Higher chance of hospital admissions due to worsening symptoms
Increased risk of mortality for certain conditions, such as heart disease or diabetes
Worsening symptoms of the patient’s current condition
Higher healthcare costs as conditions get worse due to prolonged need for care and medication and more care and medications are needed
Additional complications or comorbid conditions become more likely, especially for chronic conditions like multiple sclerosis and rheumatoid arthritis
Some medications have specific storage instructions, which can make for complex drug regimens. For example, some prescribed treatment and medication must be stored in a refrigerator while other types must be stored at room temperature.
To enhance adherence, make sure you read any storage instructions on a medication label and follow them. When possible, store multiple doses of a medication altogether to improve patient medication adherence.
What to Do After Missing a Dose
Improving medication adherence should be about taking a medication properly in the future, not correcting past mistakes. If someone misses a dose of their medication, they shouldn’t panic or double down on their next dose. Taking twice the amount the next day could have consequences, including threatening a patient’s life.
Instead, the University of California San Francisco provides some useful steps after a missed dose:
Read the label: Often, medications mention what to do if someone misses a dose.
Stay on track: Brainstorm a way to ensure you take the next medication. Solutions could include an automatic pill dispenser, a medicine tracking app, both tools, or a different way to stick to a med schedule.
Ask for help: If someone is still unsure how to stick to a medication schedule, talk to a trusted pharmacist or doctor. They can provide personalized ideas for medication adherence.
What to Do When You Have Medication Leftover
A medicine cabinet full of unused prescription drugs is common, but that doesn’t mean it’s recommended. Keeping unused or expired medicines puts you or a family member at higher risk of using an expired drug or misusing a drug in a way that wasn’t prescribed.
To safely dispose of medication, the FDA recommends removing a medication from the original package and mixing it with something less appealing, such as cat litter or coffee grounds. If a medication has harmful potential side effects or is used to manage pain from acute or chronic diseases, flush the pills down the toilet.
For detailed instructions on specific pills, explore this guide from the FDA.
Medication adherence is difficult for many Americans, but no one has to solve this issue alone. There are tools, resources, and healthcare providers who can help. Lean on them and develop a medication schedule that works.
What is adherence in medicine?
Adherence to medicine refers to taking a medication as prescribed. While this includes following the recommended frequency (daily, twice a day, weekly, etc.), it also encompasses following all instructions about a medication, such as taking a medication after a meal if recommended or stopping a medication when it’s no longer needed.
How do you measure medication adherence?
It’s difficult to “measure” medication adherence, but a physician should evaluate if a patient is taking their medication as recommended and how it's impacting a patient's health. If a patient isn’t consistent or doesn’t take medication the right way, solutions to build a medication schedule should be explored.
What are the three components of medication adherence?
The three major components of medication adherence include:
Fulfilling the initial prescription
Taking a medication as instructed
Stopping a medication when needed
Improving adherence means monitoring all three. These components should be monitored by a healthcare provider, though a patient can also ensure they take place.
What is good medication adherence?
On the surface, medication adherence may appear to be about taking a medication at the recommended frequency. In reality, good adherence has other aspects, such as taking the correct medications as recommended, storing them properly, fulfilling a prescription, and discontinuing when the prescription is no longer needed.
What is the medication adherence process?
The medication adherence process refers to the correct way to take medication. It includes fulfilling a prescription, following the instructions on how to take a medication, and stopping a medication when/if a doctor recommends it. This process facilitates the optimal outcome from a medication and minimizes the chances of a condition getting worse.