Many Americans Taking Medications Incorrectly, or Not at All: New Study
Millions of Americans do not take the drugs they are prescribed, or do not take them correctly, according to a new report by the National Council on Patient Information and Education. The report sheds light on a lesser-acknowledged aspect of the nation's health care conundrum: even when Americans have access health care services, they may not get the treatment they need to actually improve their health.
According to the report, only 51% of patients with high blood pressure take their blood pressure medication. Between 12% and 20% of patients take medication prescribed to someone else. Researchers note that Americans age 65 and older are particularly at risk of the effects of skipping medications or doses, as they have more chronic, long-term illnesses, and often take complicated combinations of drugs. Still, strong evidence shows that poor adherence to medication instructions affects all segments of the population, regardless of age, gender or socioeconomic status. As a result, the phenomenon is estimated to cost the nation $177 billion per year in direct and indirect health care costs.
Authors of the report identify 12 main factors which influence a patient's compliance with prescription drug instructions:
- "Perceptions about the nature and severity of their illness;
- Denial of illness and the need to take medicines;
- The assumption that once the symptoms improve or the person "feels better," he or she can discontinue use of the medication;
- Limited appreciation about the value of medicines when properly used;
- Beliefs about the effectiveness of the treatment;
- Acceptance of taking medications for preventive purposes and for symptomless conditions (e.g. statins to lower blood cholesterol levels);
- Worries about the social stigma associated with taking medicines;
- Fear of side effects or concern about becoming drug dependent;
- Fear of needles and the need for self-injections;
- Lack of confidence in the ability to follow the medication regimen;
- Media influence regarding safety or risk issues associated with particular medicines; and
- Lack of positive motivations and incentives to make necessary changes in behavior."
- "Using a verbal discussion reinforced with appropriately designed written materials to help the patient understand the medical condition, the need for the treatment, and the value of the treatment;
- Offering verbal counseling from both the prescribing health care provider and the pharmacist that the prescription should be filled and taken as prescribed. While written instruction sheets can reinforce these instructions, they should never be used as a substitute for counseling;
- Providing useful written information in "patient language" that clearly explains how the patient can correctly manage his / her medications. This information includes details on how to administer the medication, the exact time the medicine should be taken and why, how long to take the medicine, recognition and management steps for common side effects, special precautions, and how to monitor the progress of the therapy;
- Making patients aware of the various medication adherence aids and devices available, such as dosing reminders, pill boxes and refill reminder programs;
- Monitoring patient adherence with every visit to the prescribing health care provider or pharmacist; and
- Instructing patients and caregivers on home monitoring activities (such as home blood pressure monitoring) and home monitoring records that should be maintained for use during future medical and pharmacy visits."
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