When you’ve been diagnosed with a long-term or chronic condition, you’ll often have to take medications long term. But keeping up with your medication schedules can be a struggle.
In fact—whether because of motivation, costs, lack of understanding about conditions, overly complex prescribing information, honest mistakes like forgetting to take them or a host of other reasons—about one out of every two people does not take a prescribed medication according to directions.
But in order to get the maximum benefit from your treatment plan, it’s important to follow your prescription as closely as possible.
What is medication adherence?
Adherence is the act of taking a medication as it’s prescribed for as long as it’s been prescribed. Clinicians used to call this “compliance.” But with a shift to an understanding that patients are partners in their own care, the term changed. Now, instead of complying with—or, simply obeying—what their clinician says to do, patients instead “adhere” to the plan they’ve made with their clinician to ensure their best health.
For some people, adherence simply means that they complete their course of antibiotics as their doctor has recommended. Doing so helps ensure that they get well and stay well after a short-term infection, and using antibiotics as directed can also help tamp down the broader problem of antibiotic resistance.
But for people who have long-term or chronic conditions, adherence is more than a week-long commitment. For many patients, it’s a commitment for life.
If you have a chronic condition that requires you to take medication over the long term, knowing the obstacles that can undermine your adherence can help you avoid them—and understanding the downsides of non-adherence can remind you to stay on track.
Understand your condition
People who struggle with adherence do so for different reasons, some of them specific to the medication or to the condition that they have. But generally, there are some common factors that you can foresee and possibly control.
One main reason people stop taking medications prematurely or take them incorrectly is because they don’t understand why they’re taking them in the first place. They may not fully grasp the dimensions of their condition and how it can be treated with medication. In the case of conditions that have no symptoms—such as high cholesterol or high blood pressure—they may not realize that taking medication can improve a condition even if they don’t “feel” better outwardly.
In many healthcare situations, patients often feel as if the burden is on them to seek the information. But improving understanding of the need for a prescription is a two-way street. Doctors can work on explaining things to patients so that they understand the importance of taking their medications correctly, and patients should seek information from their doctors until they do understand.
Ask the right questions about your prescription
When it’s time for your appointment or when you’re picking up a prescription from your pharmacist, make sure you have your questions ready. You might want to ask any or all of the following:
- What condition do I have that requires this medication?
- What will the medication do for my condition?
- What is the name of the active ingredient in my drug, in addition to the brand name?
- What are the best timing and conditions for taking it (Mornings? With food?)
- Will the drug begin working immediately or take longer?
- Are there special storage requirements?
- Are there drug interactions with other medications or supplements I already take?
- Should I avoid any specific food, alcohol or activities when taking this drug?
- If I want to stop the medication, what should I do?
Getting answers you need goes a long way toward resolving many of the obstacles in the way of achieving your adherence goals.
Stick with your prescription when your condition improves
Sometimes, when a medication produces improvement, you might be inclined to stop taking it because you feel better or you begin to see progress toward improving your condition. The problem with that, especially with chronic conditions, is that stopping the medication can reverse progress.
Take statins, for example. Statins are drugs that help reduce levels of “bad” cholesterol (called low-density lipoprotein, or LDL) and other fats in the blood. These drugs can reduce the risk for stroke, heart attacks and death among people who have hardening of the arteries or increased risk for heart disease.
The hitch is that statins will work only if you take them as prescribed—if you “adhere” to your treatment plan. You might start a prescription for a statin and learn at a doctor’s visit that your cholesterol values have temporarily moved into a healthy range. But if you stop taking the drug, your values will likely climb again, setting you back on the path toward more serious heart disease.
In fact, people with heart risk factors who quit taking their statins may see an increased risk for mortality. Yet according to some research, half or fewer of patients who take these drugs don’t take them as prescribed or even quit them altogether. What’s more, as many as four out of five don’t end up hitting their target cholesterol levels, in part because these highly effective drugs go underused. The patterns are similar for people who take medications for high blood pressure.
It’s crucial to continue to stick with your medication as prescribed, even if your symptoms or numbers improve.
Stay the course when you feel worse
The other side of the coin is when your medication makes you feel bad, or you’ve taken a medication like it that previously produced bad side effects. The reality is that many drugs involve side effects, some worse or more significant than others.
When you start taking your medication, you should have a discussion with your healthcare provider about side effects. In particular, find out which ones are most common, which ones usually go away with time and which ones warrant a call to the doctor.
If you feel that the side effects simply outweigh the benefits the drug is supposed to offer, don’t stop taking it without first talking with your doctor. With some medications—such as corticosteroids, antidepressants and beta-blockers—stopping cold turkey can be dangerous.
Lower drug costs when you can
Drugs can be costly. If you find that you are becoming nonadherent because of drug costs, don’t give up. You have some options.
Your first step should be to ask your doctor whether your prescribed drug is in your insurance plan’s formulary, its list of covered drugs. If it’s not, switching to an appropriate drug that’s covered by insurance can help you save money.
You can also ask about potentially less-expensive alternatives, including generics. Generic drugs are regulated and established as direct substitutes for brand-name drugs. Check with your insurance company to see if you get more coverage for specific generics.
The companies that manufacture these drugs sometimes offer patient-assistance programs. These programs subsidize drug costs for patients who qualify based on income and other factors. You can also look into cheaper options for obtaining prescriptions: Some mail-based pharmacies offer a price break and ship a 90-day supply of some drugs for less per unit.
Automate your prescription to save time
Getting your prescriptions delivered by mail in 90-day supplies helps solve another issue with adherence: time.
It takes time to refill and pick up medications at the pharmacy. And you have to remember your refill and make sure you have refills available or you’ll risk missing doses while you wait for your doctor’s approval. Many major pharmacies offer auto-reminders for refills, by text, phone or email and will contact your doctor’s office for you to handle refill requests.
Living with—and treating—a chronic condition presents a host of challenges. If you encounter any of these stumbling blocks, don’t hesitate to reach out to your healthcare provider. Your doctor can answer any questions you have about your condition—and remind you of the myriad of benefits that come from following your treatment plan.
