Forgetting medications?
Forget to take your medicine?
You are not alone. Every second person prescribed medication for the treatment of chronic diseases does not take it as prescribed. The impact of this behavior is costly and dangerous. This nonadherence to prescribed treatment is thought to cause at least 100,000 preventable deaths and $100 billion in preventable medical costs per year. Noncompliance is not under the radar of physicians. In my experience, most patients feel embarrassed to admit their “ lack of discipline” or mistrust in prescribed medication or diagnosis. Many try to express a “ good boy or girl” behavior instead of simply saying: “ It’s a hardship for me, more than my illness”. In some cases, medication cost is a challenge, but in current health care, physicians learned to pay attention to the cost most of the time.
Focusing on barriers also distracts us from the reality that adherence rates are and will be low whether obvious barriers are present or not. Patients have a right to believe that they can make treatment decisions more or less by themselves overruling the physician’s prescription:” I know my body better”. However, those decisions are influenced by unresolved doubts and concerns about prescribed treatment from their cultural and previous experiences perspectives or misconceptions about the illness.
Research conducted on patients with a multitude of long-term conditions suggests two key beliefs influence patients’ common-sense evaluations of prescribed medicines and therefore compliance: perceptions of personal need for treatment (Necessity beliefs) and Concerns about a range of potential adverse consequences. Instead of forcing and demanding compliance with medications giving patients the opportunity to figure out the necessity of treatment, comprehend the illness a feeling of autonomous responsibility for the outcomes showed the best results. Instead of quietly agreeing to take any prescribed medication, being proactive in conversations with your doctor about the necessity of treatment, particular medication and discussion of potential side effects before initiating any treatment would help you to choose the medication that is right for you.
The true shared decision between equal partners patient and a doctor might be a challenge but is absolutely necessary for working patient-doctor relationship. Knowing patients better on a personal level, motivational factors, driving forces, including family dynamics do improve medication adherence. Patient -doctor relationship is not a speed dating model. As our parents used to say: everyone must have a priest and a doctor acknowledging the value of familiarity and privacy in communication. If you believe in the necessity of treatment, potential adverse side effects might be felt on a lesser scale.
Creating a habit around to change behavior also showed the best adherence results. Electronic App-based medication reminders are one of the ways to go.
Here is the list of top-rated Medications Reminder apps:
Medisafe Medication Reminder: Android/ iPhone is a medication reminder app that now is integrated with Health Records on the iPhone. It also checks for medication interactions, and monitors your adherence and supports family sharing.
Pill Reminder- All in one: iPhone allows you to create any type of recurring reminders, tracks the quantity of each medication, reminds you about refills and medical appointments. It also can email reports to your Doctor. It also has the ability to search the FDA Drug Database for your medications. It also has a voice-over function to remind you about the medication
Round Health: iPhone offers Apple Watch App, organizes all your medications and supplements in one place, provides beyond awkward phone alarms reminders tailored to your schedule, and send reminders for refills.
Medication reminder: Android app also performs the function of pill tracker, mood tracker, and health journal. It will also track your medicines, dose, measurements like diabetes, anxiety, depression, hypertension, multiple sclerosis.), and activities as a comprehensive health journal. In this app, you can also share your health journal with your doctor.
Medica: Android is a medication reminder app that can customize your schedule and track your pills and refills for you.
Key references:
Horne, R., Chapman, S. C. E., Parham, R., Freemantle, N., Forbes, A., & Cooper, V. (2013, December 2). Understanding patients’ adherence-related Beliefs about Medicines prescribed for long-term conditions: A meta-analytic review of the Necessity-Concerns Framework. PLoS ONE, Vol. 8. https://doi.org/10.1371/journal.pone.0080633
2. Náfrá, L., Nakamoto, K., & Schulz, P. J. (2017). Is the patient empowerment the key to promote adherence? A systematic review of the relationship between self-efficacy, health locus of control and medication adherence. https://doi.org/10.1371/journal.pone.0186458
