Medication compliance means taking all your prescription drugs as directed by your doctor—at the right the right dosages...every day you're supposed to, for as long as necessary. In other words, it means following the instructions precisely. Sounds easy, right?

Not necessarily.

Example: Longstanding research shows that about 125,000 Americans die each year because they don't take their heart medication properly.

Nearly one-third of people who are prescribed drugs don't even fill their original prescriptions. Among those who do, compliance rates follow the "rule of sixths"...

  • ⅙ are perfect in their compliance.
  • ⅙ are pretty good, but sometimes take the drug at the wrong time of day,
  • ⅙ miss a day of medication every now and then.
  • ⅙ take "drug holidays" (discontinuing medication for three or more days) three or four times per year.
  • ⅙ take drug holidays once a month or more, and frequently skip their medication for one to two days.
  • ⅙ don't comply much at all...but tell their doctors that they do.

Why So Much Resistance?

There are a variety of reasons why people don't take their medication as prescribed. Unfortunately, many doctors don't ask about compliance, and patients usually don't bring up the topic on their own.

Important: Even if your doctor doesn't ask, be sure to discuss any problems you may be having adhering to the drug regimen you have been prescribed.

If you're having trouble sticking to your medication schedule, follow up with your doctor or his/her nurse by phone or E-mail between appointments.

Another option is to keep a medication log to take to the doctor—this will give you the feeling that you are preparing for an appointment every day. Make note of any side effects or problems you're having with adhering to the drug regimen.

The top nine reasons (listed alphabetically) that people don't take their medication and my advice for correcting the problem…

  • Apathy. Some people lose interest in their health, so thus stop taking their medication.

Solution: Schedule an appointment with your doctor. Your apathy may be a sign of depression, a relatively common secondary disorder among people faced with a serious or painful illness. Your physician usually can prescribe an antidepressant, which may improve both your mental outlook and your medication compliance.

  • Conscious omission. When a doctor prescribes medication, some people feel compelled to defy authority/assert their independence.

Solution: Rather than waging an emotional rebellion, remember who stands to gain from medication compliance—if you don't take the drug, only you will be hurt...not the doctor.

  • Cost. The medication is too expensive.

Solutions: Ask your doctor if there is a generic version of your medication...or if another, less expensive medication could be substituted. Another option is pill splitting. For some medications, the cost is the same, regardless of the dose--for example, a 5-mg pill could cost the same as one that is 10 mg. By buying the higher dose and cutting the pills in half, you get twice the bang for your buck. Pill-splitting devices are available in drugstores for less than $10. Not all medications can be split-ask your pharmacist.

  • Denial. When taking medications for a 'silent" disease, such as high blood pressure, some people disregard the diagnosis, thinking that if they were really sick, they would feel bad.

Solution: Ask your doctor what the risks are in not taking the medication. For example, even if you know that a medication helps reduce blood pressure, you may need to be reminded that your risk for stroke and heart attack is increased if your blood pressure is not controlled.

  • Fear. Some people think that all prescription drugs-or a particular prescription drug will hurt them.

Solution: If you are concerned about potential side effects of prescription drugs and prefer "natural" or herbal treatments, discuss this with your doctor. He may be able to recommend a dietary supplement or to allay your fears concerning the medication.

  • Feeling better. Once the immediate health problem improves, many people cut back or stop taking the prescribed medication.

Solution: Realize that doctors prescribe medication according to specific dosing schedules so that the medication builds up in the bloodstream. If you stop taking an antibiotic, for example, you may not eliminate all the bacteria causing an infection. "Drug holidays should be avoided, because skipping days may cause fluctuations in the blood levels of medication, which can make the drug less effective.

  • Forgetfulness. Memory problems, as well as having other priorities, cause many people to miss taking medication

Solutions: Count doses in advance and store them in a compartmentalized pill storage box. One- or two-week containers are available at most supermarkets and drugstores.

It also helps to put medication in a place where you are most likely to see it. For example, if you take it in the morning, store the medication near your coffee mug or in the utensil drawer. If the medication must be refrigerated, place a reminder note near your mug or in the utensil drawer.

People who own cell phones, personal digital assistants or computers with an alarm feature can set these devices to ring at the same time every day. Pocket-sized alarms used solely as a reminder to take medication are available in drugstores for about $6 to $10.

  • Lifestyle. Travel, inconsistent work or home hours, or a generally busy schedule can interfere with medication compliance.

Solution: Keep your medication stored in a pill box and leave it where you will be sure to see it-such as on a bedside table—whether you're at home or traveling.

  • Side effects. Nausea, headache, drowsiness and upset stomach can occur with many medications.

Solution: Your doctor usually can change the prescription, give suggestions about other ways to take the medication—for example, with food—or prescribe an additional drug to counteract the side effects.

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