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11/13/2013

Why Don’t You Take Your Medication?

It is a question that thousands of pharmacists and health care professionals ask their patients on an almost constant basis; but many times this inquiry falls on deaf ears and the patient remains noncompliant. It is a frustrating reality that approximately 50% of patients are non-adherent to their medication regimens. It is common knowledge that these patients can’t achieve their therapeutic goals if they don’t take their medications as prescribed and adherence is the key mediator between medical practice and patient outcomes. As pharmacists, we should take a closer look at WHY our patients don’t take their medications, and what we can do about it.

Fear:   While modern medicine can save lives and cure disease, the fears many have towards medications can prevent these people from being helped. Fear is a powerful influencer and it can manifest itself in many ways. A patient could be afraid of a startling side effect, the risk of drug addiction, fear of needles, or even the negative stigma that taking a medication has in society as is the case for drugs associated with mental illnesses. Culture can even have an impact if the prescribed medicine is in contradiction to the patient’s religious beliefs.. As pharmacists, it is important for us to interact with patients and assess their attitude towards their therapeutic plan. It is vital to identify fears they may have and help alleviate their anxiety or hesitation. For example, if a patient is frightened of a rare side effect, framing the risk of developing the side effect with real data may reduce the fear.  If the patient has a phobia of needles it might be possible to alter the therapy so that injections or needles can be avoided. While it is unrealistic that we can calm all the fears patients may have, it is possible that with proper communication and education, many of these fears can be minimized.

Confusion and poor health literacy:   "Take two tablets by mouth twice daily." To a trained pharmacist or student like myself, those instructions appear clear and concise, yet a study revealed that nearly half of all people who read them misunderstood them. And with 81% of older adults taking one medication with 29% of them using five or more prescription medications, confusion can easily arise from multiple drug regimens and multiple disease states. It is the pharmacist’s responsibility to limit confusion as much as possible. This can be achieved by writing simple instructions on prescription labels and communicating with the patient in a counseling session. Nothing should be assumed and every aspect of the medication should be addressed with the patient. It should be stressed to the patient that there is no such thing as a stupid question. It is a fact that a poor patient-pharmacist/physician relationship hurts the chances of patients actually taking their medicine as prescribed.

Fear and confusion are only a few of the barriers that pharmacists encounter when trying to improve medication adherence. In the next blog we will examine and discuss health beliefs as a barrier to medication adherence and what we as pharmacists can do to improve outcomes.

Mackenzie F. Blair, PharmD ‘15

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