Prescription Drug Adherence

Prescription Drug Adherence

Prescription Drug Adherence
When your doctor prescribes you a medication, he or she should be very clear as to when and how to take the medication. Filling your prescriptions on time and taking them as directed leads to proper medication adherence. Medication adherence may not be easy for you if your finances are strained. Or, you may forget exactly when to take your medication, which can reduce its effectiveness. Medication adherence is especially important if you are prescribed an antibiotic. Failure to use antibiotics properly can worsen your symptoms or lead to antibiotic resistance. If you are unable to pay for your medicine, unsure of which medications to take, or don't remember when to take them, contact your doctor.

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    Heart disease patients who do not take their medication as prescribed are at greatly increased risk of complications or coronary events such as heart attack. A common reason patients give for not taking their medication is that they cannot afford to purchase it. That is a legitimate worry, but absolutely nothing is more important than your health. If you are concerned about the financial costs of medication, talk with your prescribing physician, pharmacist or a hospital social worker. These professionals can help you identify prescription assistance programs that are appropriate for your situation.

    Most prescription assistance programs are services set up by pharmaceutical companies to provide uninsured low-income or disabled patients with free or reduced-cost prescription medications. The programs help patients with obtaining medically necessary medications for which they do not have insurance coverage. Non-profit and governmental prescription assistance programs may be available in your state as well.

    The key message is that financial barriers must not stand in the way of you taking care of your heart health. If you need financial assistance for prescriptions, there is help available.

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    Patients’ reasons for non-adherence are varied and complex, though researchers have identified some common predictors of poor adherence. These include:

    • psychological problems, particularly depression;
    • cognitive impairment;
    • asymptomatic disease;
    • inadequate follow-up or discharge planning;
    • side effects of medicine;
    • patient lacks belief in benefit of treatment;
    • patient lacks insight into the illness;
    • poor relationship between patient and provider;
    • missed appointments;
    • lack of health insurance;
    • cost of required copayment or coinsurance;
    • complexity of treatment;
    • access restrictions.
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    A , Neurology, answered
    Keep track of medication times by using one of the following methods:
    • Purchase a digital sports watch with a countdown repeat timer; this works well if you need to take medication at a regular interval, such as every 4 hours. With this feature, the watch beeps after 4 hours, then automatically starts counting down to the next 4-hour interval. They come in both men’s and women’s styles, with metal or nylon bands. If you don’t want to be disturbed by the watch beeping in the middle of the night, take it off and leave it in another room.
    • Purchase a “double-alarm” alarm clock. Because morning pills and evening pills are the easiest to re- member, set the alarm to go off, for example, at 12:00 P.M. and 4:00 P.M. After the alarm rings at 4:00 P.M., press the reset button and the alarm will automatically sound the next day at 12:00 P.M.
    • Program your cell-phone alarm. Most cell phones allow you to set several alarms for daily or intermit- tent reminders; they also may have a quick alarm that will ring in a set period of time (such as every 4 hours). Use one or a combination of these alarms to remind you of your medication schedule.
    • An electronic timer reminds you when to take your medication. The MedGlider System has three alarm types (beeping alarm, voice alarm, or visual alarm) that can each be programmed to alert you up to three times at 1-minute intervals and for four dose settings. The LCD screen is large, clear, and easy to read, displaying the current time, the number of daily doses selected, a missed pill alert, and an alarm mode. It has large buttons and separate hour and minute but- tons for easy programming. The MedGlider timer, which requires two AAA batteries (not included), may be attached to a four-compartment pillbox and is small enough to conceal in a coat pocket or purse.
    • A vibrating locket discreetly reminds you to take medication. The Chronostone Personal Timer is a convenient and attractive alternative for aiding women in taking medication on time. Set the alarm, and the locket silently vibrates at the same time each day, with a “second chance alarm.”
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    Pharmacy benefit design has an important, direct influence on adherence to medicines. Higher copays and restrictive benefits lead to a reduction in use of medicines and can increase total medical costs in the long run.

    A synthesis of the literature by researchers at RAND Health found a 2-6 percent decrease in prescription drug spending for every 10 percent increase in cost sharing (depending
    on therapeutic class and patient outcomes). Researchers also found an unambiguous association between higher medication copays or cost-sharing and increased use of hospitalizations and emergency medical services for patients with congestive heart failure, lipid disorders,
    diabetes, and schizophrenia.

    Compared to seniors with uncapped prescription coverage, seniors with a $1,000 annual benefit cap under a Medicare+Choice plan were less likely to use medicines appropriately and experienced unfavorable clinical outcomes. Use of medicines to treat hypertension, high cholesterol, and diabetes was 15 percent, 27 percent, and 21 percent lower, respectively for patients subject to
    the cap relative to those with full coverage. The cap was also associated with poorer control of blood pressure, lipid levels, and glucose levels, and savings from reduced use of medicines were offset by increases in the costs of hospitalizations and emergency care.

    A 2004 RAND study found that doubling copays for medicines reduced adherence by 25-45 percent. As
    patients’ use of medicines declined due to increased copays, emergency room visits increased 17 percent and hospital stays rose 10 percent among patients with diabetes, asthma, or gastric acid disorder.
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    A Oncology Nursing, answered on behalf of

    In most hospitals here are standards of treatment (or protocols) for specific illnesses. These are the most researched and effective treatments for that illness. Doctors will often use these protocols that are already in place to decide which drug to use, but may change dosing due to the patients general health or other variables.

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    A Thoracic Surgery (Cardiothoracic Vascular), answered on behalf of
    Medication compliance for a medical condition can be monitored. Pharmacy dispensing devices for the home are available. The These devices can remind you of your medication times, monitor if you're taking your medications and send reports to the "cloud" online, where lack of compliance can be detected and sent to your nurse practitioner, doctor or pharmacist.
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    A Nutrition & Dietetics, answered on behalf of
    The Food and Drug Administration (FDA) considers all new drugs to be unsafe until they are proven safe by clinical trials, and the FDA must approve any new drug before it can be legally sold in the US. The FDA approval process requires that any new drug be proven in a series of clinical trials. These studies must show "substantial evidence"  that the drug is both safe and effective for each of its intended uses.  Once the FDA approves the drug. it must be manufactured under carefully monitored conditions and packaged with complete information on the best dose and schedule.

    In 1994 the Dietary Supplement Health and Education Act (DSHEA) defined dietary supplements as a category of food, which placed them under different regulations than drugs. They are considered safe until proven otherwise.  The DSHEA says that dietary supplements cannot contain anything that may have a significant unreasonable risk of illness or injury. But manufacturers are not required to test new ingredients or supplements in clinical trials which would help find risks or potential interactions with drugs or other substances.  Dietary supplements are found unsafe only after they cause harm. This is the reverse of the way prescription and non-prescription drugs are treated.

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    A Oncology Nursing, answered on behalf of
    It is important to know about drug side effects, so you can know what to look for when taking a new drug. When prescribed a new drug from the pharmacy please look at the most common side effects and be prepared that they may or may not happen to you. It is also important when taking a new drug to know your body and trust your instinct. There are more rare side effects or even allergies that can occur.
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    While it has not been officially established that Lariam can lead to suicidal thoughts and paranoia, Roche Pharmaceuticals, the manufacturer of the drug, warns about the potential for patients using the drug have suicidal thoughts. Its warning also includes that there have been rare reports of suicides.

    In 2005, the Army stopped routinely distributing Lariam-which is used to treat and prevent malaria-to its troops overseas.

    Another drug, Paxil (generic name paroxetine) is a antidepressant that is prescribed to treat conditions ranging from depression to post-traumatic stress disorder.

    However, many patients taking Paxil have reported suicidal thoughts. In 2003, the federal Food and Drug Administration advised that Paxil should not be prescribed to children and adolescents for the treatment of depression because of this potential risk.

    The FDA later expanded that advisory to include adults up to age 30.

    Numerous lawsuits are pending that allege Paxil's role in suicides and suicide attempts, in addition to severe withdrawal symptoms that some patients have gone through.

    Documents presented in one law reveal that GlaxoSmithKline, Paxil's maker, may have hidden data that demonstrates a link between the drug and increased thoughts of suicide.

    Chantix can also lead to suicidal thoughts. In February 2008, the FDA issued a warning that Chantix could not only increase the possibility of suicidal thoughts, but also of actual suicide. The FDA reports that at least 40 suicides and 400 attempted suicides have been linked to Chantix.

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    Chantix (generic name varenicline) Is a prescription drug prescribed to help people to kick the smoking habit. But some users also report having nightmares and night terrors.

    Night terrors are more than just scary dreams. People who have night terrors are so struck by fear that they partially awaken from their sleep-sometimes moaning or screaming. They usually to not awaken completely during these episodes and sometimes do not recall the incident even happened.

    Users of Lunesta (generic name eszopiclone) as well as Ambien (generic name zolpidem), have also reported nightmares and night terrors and nightmares. But users of both of these medications also have experienced an even weirder side effect. They have performed activities while they were asleep.

    These activities have included sleepwalking, making phone calls, having sex, eating and believe it or not, driving.

    Patients taking these sleep aids have reported that they have awakened while backing their cars out of driveways or while shopping at all-night grocery stores.

    Some "Ambien drivers" even have been arrested for causing accidents.

    Makers of both of these drugs have included warnings about these potential side effects. They also emphasize that the medications should not be taken with alcohol, which can heighten the effect.