Only half of patients taking meds follow instructions
Prescription drugs are amazing tools when used correctly, making people healthier, fighting off illnesses and saving lives. As such, it should seem like common sense to use prescriptions in the ways they were intended, but according to a new review published in the Cochrane Library for health information, fewer people may be following these instructions than once thought.
According to the research led by Dr. Robby Nieuwlaat of McMaster University School of Medicine in Ontario, Canada, only half of patients using prescription drugs are taking the medication as prescribed, doing everything from skipping doses to overdosing to just stopping their therapies all together. Obviously, this is a problem – in the review, Dr. Nieuwlatt identifies that prescriptions are made for a reason and that not paying attention to instructions can have dire consequences.
Inspired by the realization that adherence rates were so low, the research team began to look into trials that had been done in order to test strategies to increase adherence, 182 in all. However, Nieuwlaat’s team discovered something just as disturbing as low therapy adherence rates in their research: nearly all of the trials tested were flawed in some way, ultimately leaving the team without answers.
“The studies varied so much in terms of their design and their results that it would have been misleading to try and come up with general conclusions,” wrote Nieuwlaat in the study. “Based on this evidence, it is uncertain how adherence to medication can be consistently improved.”
While Nieuwlaat and his team are unenthusiastic about the potential of any program to have a measurable effect on the rates at which patients are correctly taking their prescriptions, other experts, like Dr. Caitlin Ash, a clinical pharmacist at Advocate Condell Medical Center in Libertyville, Il., see some strategies as more effective than others.
“I find it a little surprising that there would be no solutions to this problem,” Dr. Ash says. “While there may be no way to definitively solve the problem, patient education and counseling can go quite a long way.”
Despite the success that Dr. Ash has had with training and education, she still maintains that it is almost impossible to deliver the same amount of instruction to every patient. Counseling time is often devoted to patients with diseases a high risk of readmission, like heart failure and COPD.
While problems like pharmacist availability and resources are clear problems, and previous research has not yielded any concrete solutions, Dr. Nieuwlaat is hopeful that a solution may eventually present itself – as a result of his work, Nieuwlaat and his team have created a database of all the trials conducted in the field thus far, making information far more accessible to future researchers.
“By making our comprehensive database available for sharing,” Dr. Nieuwlaat wrote, “we hope to contribute to the design of better trials and interventions for medication adherence.”
About the Author
health enews staff is a group of experienced writers from our Advocate Health Care and Aurora Health Care sites, which also includes freelance or intern writers.
I think you misspelled Dr. Nieuwlaat’s last name. It does not appear to be Nieuwlatt.
Thanks for catching our error! We have edited.
As an Advocate Hospice Admission RN, I routinely discover medication discrepancies on many of the initial home visits I do. There are medication duplicities, poly-pharmacy, nonadherence, etc in many home settings. My experience is that medication reconciliation and education at the point of care works the best to reduce errors and improve medication adherence. When I call to make my initial visit, I ask patients/families to have all the meds they are taking, prescribed/OTC/supplements, available for the visit. A medication reconciliation is completed with the primary MD managing the patient’s care to determine the appropriate current list. A “My Medications’ list developed at Advocate at Home clearly stating current medications/times to take/indications/dosing and possible side effects is given to the patients/families for easy reference. Families are asked to destroy non-current medications. This list is then referenced/reviewed/updated at each subsequent case manager visit. It takes time and when done correctly, may result in improved medicaton adherence, improved patient quality of life indicators and a reduction in medication errors.