It's time to take your medicine — seriously

Emily Mongan
Emily Mongan

Every so often I'll log onto Facebook and see a status asking for suggestions for remedies for illnesses or injuries. Aside from the fact that there's an incredibly low chance that anyone replying to these posts is actually a medical professional, they always raise a red flag for me for one major reason.

At least one commenter will ask the poster if they've gone to the doctor or tried taking medicine, and the answer is almost always no.

On the last two such posts I saw, the poster replied she didn't want to take medicine as prescribed because of the possible side effects. So instead, she listens to whatever acquaintance replies to the status with a suggestion to gargle some essential oils and garlic instead of, you know, actually going back to the dentist about that toothache.

It's a problem that's widespread enough that it turned up in the New York Times on Monday: people are really bad at sticking with their medications. A recent review found that 20% to 30% of prescriptions are never filled, while nearly 50% of medications prescribed for chronic conditions aren't taken according to doctors' orders.

People not following their doctors' medication orders contributes to an estimated 125,000 deaths and 10% of hospitalizations per year, along with somewhere between $100 billion and $289 billion in healthcare costs.

Like the geniuses on my Facebook page, much of this non-adherence stems from a fear of side effects or ingesting anything deemed “unnatural.” Others will simply stop taking their medications once they feel well, or avoid them altogether for chronic conditions since “medications remind people that they're sick,” the NYT report found.

The problem reaches medications prescribed for dementia as well, with a recent study from Indiana University and the Regenstrief Institute finding only half of individuals prescribed such drugs continued to take them after 18 weeks.

“Physicians should be aware of the impact of side effects, many of which are shared with other medications that the patient is taking, on both the adherence to the medication and quality of life,” said lead researcher Noll Campbell, PharmD. “While these drugs aren't the answer to Alzheimer's disease, improving tolerability and adherence may reduce the complications of the disease.”

Similar suggestions were given by the experts interviewed in the NYT report, with some recommending physicians to inform patients about possible side effects to assuage fears before they fill a prescription. Other tricks, like packaging multiple drugs for certain conditions together or using of a smartphone app to remind patients to take their medications, could also make medication adherence easier and less daunting for patients.

As long-term care providers you likely have better control over residents' medication adherence than a physician a patient sees once a year would. But the adherence epidemic is one to pay close attention to, as it may bring a resident back to your facility sooner than later — or keep your own employees out of action longer than necessary.

Follow Emily Mongan @emmongan

Daily Editors' Notes

McKnight's Daily Editors' Notes features commentary on the latest in long-term care news and issues. Entries are written by Editorial Director John O'Connor, Editor James M. Berklan, Senior Editor Elizabeth Newman and Staff Writer Emily Mongan.

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