Medication Adherence Mistakes May Include:
- Failure to fill or refill a prescription
- Prematurely taking or discontinuing medication
- Taking the incorrect medication
- Taking more medication than was prescribed
- Omitting one or multiple doses
- Improperly using devices such as inhalers or syringes
- Taking medications with prohibited foods, liquids or other medications
- Taking medications that are expired, damaged or stored improperly
How Big Is the Problem?
- More than 125,000 people die each year due to prescription medication non-adherence, twice the number killed in car accidents.
- 9 out of every 10 hospital outpatients are taking prescribed medicines improperly.
- Poor medication adherence has also been linked to unnecessary disease progression and complications, reduced functional abilities and nursing home admissions.
- People who miss doses need three times as many doctor visits as others.
- Up to 59% of those on five or more medications are in non-adherence.
Following are a number of strategies to assist with common causes of medication non‑adherence.
SOCIAL ISOLATION: Studies show that people who live alone more often fail to comply with medication regimens.
- FINDING A SOLUTION: A professional in-home caregiver can provide companionship as well as gentle medication reminders.
INCOME: Elders who can’t afford medications may split pills, cut back the dose, or go without for long stretches of time.
- FINDING A SOLUTION: Research prescription assistance and ask the pharmacy about discount programs. Ask the physician if a generic drug or another brand in the same drug class is available at a lower cost.
SWALLOWING PROBLEMS: Elders who have trouble swallowing may try to chew, crush, break, or mix the tablet in food or drink, causing long-acting medications to be released into the body too quickly.
- FINDING A SOLUTION: A doctor or pharmacist may be able to provide the same medication in a smaller tablet or a liquid form.
MEMORY LOSS: People with dementia or Alzheimer’s disease may forget to take their medications, or people with multiple prescriptions may have trouble remembering when to take each medication, resulting in skipped doses or overdoses.
- FINDING A SOLUTION: Tie the medication-taking process to other daily routines and use medication dispensers or charts to stay organized. Available products include computerized pill box dispensers that call a designated phone number if pills aren’t taken, watch alarms and necklaces with audio reminders. Additionally, a trained in-home caregiver or home health professional can assist with medication reminders.
DIFFICULTY OPENING PILL BOTTLES: Due to arthritis and weakness, elders may give up taking medications if they have trouble opening the pill bottles.
- FINDING A SOLUTION: Ask the pharmacist to provide easy-open pill bottles. To improve the grip of the pill bottles, try wrapping several rubber bands around each bottle.
DOESN’T UNDERSTAND REASON FOR DRUG: Many seniors take five or more medications, leading to confusion regarding the purpose of each medication and the consequences of not taking them as prescribed. The elder may feel good and reason he doesn’t need to take the medication. He may also perceive the treatment benefit to be small compared with the cost and thus not take his medications.
- FINDING A SOLUTION: Trained in-home caregivers or home health professionals can teach the importance of each medication, instruct on disease management and provide medication reminders.
FEAR OF ADDICTION OR SIDE EFFECTS: Many avoid medication or reduce the dosage, fearing adverse side effects such as sedation, constipation, or sexual problems.
- FINDING A SOLUTION: Discuss fears with the physician. It is possible that an alternative medication can be prescribed. Through regular in-home care, a professional caregiver can help monitor for first signs of adverse side effects and report to others before it becomes problematic.
Sources: Disabled-World.com, Aging Well Magazine, Senticare