Ask yourself these questions: Do you sometimes find it difficult to take medication as it has been prescribed? Have you ever forgotten to take your medication? Have you ever stopped a prescription without telling your doctor? Have you ever wondered what the medication you have been prescribed is actually for and what side effects it may have?
If you answer “yes” to any of these questions, you are not alone. Whenever patients get any kind of medication, the instructions are to “take it as directed”, but do people know what that means and why it is important to take it properly?
Too many people do not stick to their treatment and drop-off rates can be as high as 50%. A United States survey found that patients with chronic illnesses such as high blood pressure often took only 50% of a prescribed dose — and half of them stopped their treatment within the first year. About 85% of patients stopped taking their cholesterol medicine after only six months. Of seven chronic-medication patients who received a script, six filled it initially, only four had it refilled, and by the fourth month only one person was still taking the medication. South Africa is no different.
“Non-compliance results in resistance and the worsening of symptoms,” said Zane Wilson, founder of the South African Depression and Anxiety Group (Sadag).
Patients often do not fill initial prescriptions because they are not convinced they really need the medication. Many people forget to take some of the dose or forget to take their medication with them when they leave home or go on holiday.
Others do not take the medicine correctly. They share their dose, do not take it at the right time or store it inappropriately, which means the medicine does not work as effectively. Many, because they feel better or do not like the side effects, decide to stop taking their medication without consulting their doctor. “In the case of treatment for mental illness, abruptly stopping your medication often means the return of symptoms and a worsening of the condition,” said Wilson.
Not taking medication correctly is risky and costly. In the US, 36% of kidney transplant losses are caused by patients not taking their medication correctly. Non-compliance can also lead to withdrawal and resistance. “Every time a patient stops taking certain medication, the dose may need to be adjusted before he or she can start it again to prevent side-effects,” said Wilson.
Compliance with treatment increases when patients feel they are part of the decision-making process and when they understand what they have been prescribed and why.
Healthcare literacy is critical to compliance. Sadag runs an innovative patient medication compliance programme to help people diagnosed with an illness that requires long-term medication. It helps them to know what to expect and how to manage short-term, common side effects.
“This compliance programme helps to give patients a positive alternative to stopping their treatment and the support and motivation to be compliant,” said Wilson. Sadag speaks to patients telephonically when they join the programme to get an idea of the treatment they are on as well as their concerns.
“For the first eight weeks, we send SMS reminders to take the medication, we motivate through SMS and provide access to brochures, counselling, skills and tips on handling side effects, as well as information about support groups,” said Wilson.
Sadag’s tips for compliance:
Know what you are taking. More than 100 000 Americans die every year because of unexpected complications from mixing medication. Aside from knowing what you are taking, tell your doctor and pharmacist, know what reactions the medication may have on other pills or alcohol and ask about side effects.
Know how much you are taking and when. Make sure you can read your doctor’s handwriting and that your pharmacist can too. Mistakes happen because of illegible handwriting — the wrong medication is given or the incorrect dosage. If the medication does not appear to be what your doctor described, ask the pharmacist to check it for you.
Keep a schedule. Taking your medication at the right time is a crucial part of the treatment. Make your medication part of your daily life by knowing when you will be more likely to remember them: at breakfast, after brushing your teeth or at bedtime, and speak to your doctor about it. The easier it is for you to remember, the more likely you are to get well and stay healthy.
Set alarms, write notes, have a calendar. If you are not good at remembering your medication or treatment, leave yourself notes to remind you. Set an alarm to go off every day when you need to take your medication. If you have to take a variety of pills, make a daily checklist of what you need to take and when. Keep your pills in a daily pill organiser and tick off each dose after you take it. This will help you to avoid either missing or doubling up on a dose.
Always keep your medication with you. If you work long and unpredictable hours, or know you may be late one night and have to take your medication, keep it with you. Do not forget to pack it when you travel and take a prescription with you just in case. Support is key. Friends and family can help to motivate you to stick to your treatment and remind you to take your medication when you are supposed to do so. “Successful treatment is integrated with diet, exercise and lifestyle,” said Wilson.
Discussing any questions or concerns you may have with your doctor and pharmacist helps to alleviate unnecessary stress, encourages you to stick to treatment and empowers you to take responsibility for your health.
Interested patients, pharmacists or doctors can contact Sadag. Telephone: 0800 753 379