Many People Fail to Take Medicines

Forgetfulness, Concerns Are Common Reasons

From the WebMD Archives

June 2, 2004 -- As many as half of patients newly diagnosed with a condition stop taking their medications to treat the condition, and it is often intentional, say researchers.

After surveying nearly 260 patients newly diagnosed with a condition that requires daily medication, British researchers found that after just 10 days, nearly one in three was not taking the new medicines as prescribed. After one month of initial diagnosis, one in four patients was taking these lifesaving drugs incorrectly or not at all.

"Approximately half of nonadherence was unintentional, frequently because the patient was forgetting to take their new medication," researcher Nick Barber, PhD, FRSM, of the University of London School of Pharmacy, tells WebMD. "But the other half was intentional, often related to patients' beliefs about the medication and concerns about taking it."

Lack of Information?

Barber says it is because patients don't get enough information from their doctors or pharmacists when getting a new prescription for daily-needed drugs to treat conditions such as asthma, diabetes, high cholesterol, or rheumatoid arthritis.

Most of those surveyed felt they needed more information about the drugs they received, and two in three patients who continued to take their medicines after 10 days said they were having problems with it -- including unexplained side effects. After four weeks, half of those surveyed were having problems.

"Patients newly started on a medication for a chronic condition demonstrate a substantial unmet need for information and support," he says. "They are not getting the right information at the right time."

Barber's study, published in the June issue of Quality and Safety in Health Care, follows several previous findings indicating that between 30% and 50% of patients with chronic conditions either stop taking their medication or fail to take them as prescribed. For his study, patients were interviewed by telephone and completed a questionnaire.

In this study, rising drug costs cannot be blamed, since all of Barber's study participants received their medications under the U.K.'s socialized medical care plan. However, a recent study in the U.S. shows a 20% to 35% reduction in use of prescribed drugs when insurance co-payments were doubled.

Ask Questions

Instead, these findings show that doctors aren't monitoring their patients after starting them on a new drug regimen, so patients need to be more proactive.

"They should ask about their condition and how their medication will help it," says Barber. "However, even if patients were given full information in the consultation then they would still need support with their medications, as some problems will not arise until the patient has experience with taking the medication."

However, one expert who studies the reasons why people take -- or don't take -- their prescribed medication disagrees that better patient education is the answer.

"There is little real evidence that a lack of information about a drug is to blame for a patient's noncompliance," says Joyce Cramer, associate research scientist in the department of psychiatry at Yale University School of Medicine. "Several studies, including my own, show that if you give people medication education classes, they will improve scores on knowledge about their drug, but it will not affect their compliance rates."

Lack of Organization to Blame

So what causes the typical patient who should be taking daily medication to take it only three of every four days?

"A lack of organization," Cramer tells WebMD. "If you are organized and develop what's called a cueing technique, you will be more likely to follow the prescribed regimen." Her advice:

  • Have a plan. "Decide when you are going to take your medication, what time is best for you, and stick to that schedule," she says. It may be best to take your pills as part of a daily ritual, just as you would do with brushing your teeth each morning or night.
  • Keep tabs with pill boxes. "I'm really fond of those plastic pill containers that have separate boxes for each day's pills. This way, you fill each box once a week and at the end of the week, if the boxes aren't empty, you know you didn't take what you were supposed to."

Show Sources

SOURCES: Barber, N. Quality and Safety in Health Care, June 2004; vol 13: pp 172-175. Nick Barber, PhD, FRSM, professor, department of practice and policy, School of Pharmacy, University of London, U.K. Joyce Cramer, associate research scientist, department of psychiatry, Yale University School of Medicine, New Haven, Conn. Goldman, S. Journal of the American Medical Association, May 19, 2004; vol 291: pp 2344-2350.
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