Tried-and-true methods, plus the latest electronic reminders and gadgets.
Taking medications as your doctor prescribes—known as medication adherence—is a key to staying healthy and managing chronic symptoms. But nonadherence is a serious public health problem. Nearly three out of four Americans report that they do not always take their medication as directed, a problem linked to more than a third of medicine-related hospitalizations and nearly 125,000 deaths each year, according to the National Consumers League. “It’s unfortunate. We have many medications that can help people avoid common and deadly diseases,” says Dr. Aaron Kesselheim, an internist who studies medication use at Harvard-affiliated Brigham and Women’s Hospital.
Why it happens
There are a number of reasons why people find it hard to stay on medication regimens prescribed by their doctors. “Cost is one of the biggest. People are prescribed a brand- name drug that they can’t afford, but a more affordable generic may be just as effective,” says Dr. Kesselheim. Other reasons for nonadherence include medication side effects that people don’t like, or a lack of understanding about why a medication is necessary for good health. Forgetfulness is also a common problem that can sabotage a medication routine. “Sometimes it’s just hard to keep track if you’re taking a dozen medications at different times of the day,” says Dr. Kesselheim.
Tips and strategies
When your doctor hands you a prescription, make sure you understand what it’s for, what the name of the drug is, how much you need to take and when, and what will happen to you if you don’t take it. Write down the information, ask for a printout, or bring a buddy or a partner to act as your scribe or advocate.
If a drug cost is too high for you, talk to your doctor or pharmacist about more affordable options, such as generic drugs. A number of large chain stores (Walmart, Target, Kroger) offer 30- and 90-day supplies of dozens of generic drugs for as low as $4 and $10. If you must stick to a brand-name drug, shop around for prices, and see if you qualify for prescription assistance programs through the drug’s manufacturer. One useful website is GoodRx.com, which offers the opportunity to comparison shop for drug prices, as well as links to coupons.
If forgetfulness or a busy lifestyle keeps you from sticking to a medication routine, you may need to develop a strategy to stay on schedule. Suggestions include asking for reminders from family; using a seven-day pillbox; setting an alarm on your watch, phone, or clock; making a chart that shows when to take your medicine; keeping track of when you take medications in a journal; and taking a dose at the same time each day—perhaps even linking it to another daily activity, like brushing your teeth. It may also help to ask your doctor if it’s possible to reduce the number of medications by eliminating any that aren’t absolutely necessary, or to see whether combination drugs, which include two or more active ingredients in one pill, are available for your condition.
Computers, smartphones, and other gadgets can help improve medication adherence. Consumers can choose from such devices as automatic pill dispensers that pop out the right pills at the right times; pillboxes with timers and alarms; electronic caps that fit on prescription vials and beep when it’s time to take a medication, then record when the cap was removed, indicating that a pill was taken; and applications for computers and smartphones that can organize pill information and remind you when to take them.
Pharmacies and even insurance companies are also using technology to improve medication adherence. Some offer programs to call and remind you to get a prescription refilled, or programs that estimate when you’ll finish a medication and automatically refill the prescription, then call to remind you. Pharmacies also offer bubble or blister packs that organize several different medications into morning, afternoon, and evening packages, so you don’t have to open numerous pill bottles.
On the cutting edge is technology built right into packaging and even into pills themselves. Both can transmit signals about when you’ve taken your medications. “These aren’t widely available and are still being tested. But one day a lot of these systems could be able to integrate with your physician, all with the goal of improving adherence and health,” says Dr. Kesselheim.