Why it’s a Bad Idea to Skip Meds

Every day, millions of people – on purpose or unknowingly – take prescription drugs incorrectly. Whether they skip a dose, take it at the wrong time, use too much or take too little, it can keep medicine from helping like it should.

Two studies of rheumatology patients at the MD Anderson Cancer Center in Houston show that adherence rates are low. The first study, of 110 people with RA who were prescribed disease-modifying anti-rheumatic drugs (DMARDs), found an adherence rate of 59 percent. In the other study, of 74 patients with lupus who were prescribed prednisone, the adherence rate was 64 percent. In both groups only one in five patients took their drugs as prescribed at least 80 percent of the time.

Not following a prescribed treatment plan can have serious consequences.

If you don’t take your medication as prescribed, you will experience a worsening of pain and possibly progression of the disease. If you’re taking medicine for chronic pain, skipping medication can make pain harder to treat. Non-steroidal anti-inflammatory drugs and analgesics, for example, are used as much for prevention as treatment. When pain and inflammation flare or buildup it, can be harder to suppress. So even if you’re feeling okay now, skipping medication may set you up for bigger problems later.

Express Scripts, which administers large prescription drug programs for various health insurance plans, has been studying medication adherence issues among 850,000 of its members since February 2011. They’ve identified several major obstacles: 

• Procrastination involving either renewing or refilling prescriptions 
• Cost issues 
• Forgetting 
• Concerns about the drugs themselves

Fortunately there are ways to get around these common obstacles. Learn to improve your medication adherence with these solutions to common problems.

Problem: Forgetting to take medication.
Solution: Use gimmicks and physical reminders like pill organizers, calendars, beeping computers, smartphone apps, text messages and medication charts.

Problem: Procrastinating with refills and renewals.
Solution: Many people are fine taking a medication but delay getting their refills. Try getting a 90-day supply or consider an auto-refill program or home delivery, if available. When you receive a new prescription, make an appointment for several weeks before it will need to be refilled – even if that’s a year away, since doctors can be booked months in advance. Physicians sometimes phone renewal orders to pharmacies, but don’t plan on this, your doctor may need to examine you before re-prescribing.  

Problem: Coping with costs.
Solution: Medication costs can be prohibitive, but there are often lower-cost alternatives. Talk to your physician or pharmacy about generic versions. Also check if you meet financial requirements for patient assistance programs, generally funded by manufacturers.

Problem: Keeping up with multiple medications.
Solution: Medication regimens can be difficult to follow, particularly if you take multiple drugs. Ask about combination or long-lasting drugs. They may or may not be preferable in terms of safety record, cost, side effects and effectiveness, but they can be taken less frequently. Another option is to make an appointment with your pharmacist to go over all the medications you take and how to streamline them, if possible.

Problem: Dealing with side effects.
Solution: It’s hard to take a medication faithfully if you know it will upset your stomach, make you drowsy or cause other unwanted effects. Always mention side effects to your doctor. He or she might be able to offer a similar medication that won’t have that particular effect, or let you know if the side effects will diminish as your body acclimates to the drug. Side effects may also lessen if you take the medicine in a different form, on a different schedule, or with food or supplements.

Problem: Overcoming medication anxiety.
Solution:  If you are concerned that a drug is dangerous or isn’t working as it should, have an honest discussion with your pharmacist or other healthcare provider. Learning specifically how a medication can help and how it works makes it easier to follow directions and maintain the daily regimen, even when you’re feeling healthy.

Problem: Dealing with self-image concerns.
Solution: Learning that you need a daily medication can rattle your sense of being vital and healthy. Just take it one day at a time and eventually taking this medication every day will become a normal part of your daily life.