Health Column: Are you taking your medicines?
MOHLER’S MEDICATION MAXIMS
Free Press Health Columnist
The headline reads like an extraordinarily paternalistic physician berating his supposedly non-compliant patient. Does the doc have reason for concern? A newly published study suggests that 33 percent of all new prescriptions are never filled.
Even for this old skeptical physician, a third of all new prescriptions being discarded seems high, but multiple studies over the last 40 years have shown the same pattern. I could hardly believe it during my first year in practice when my receptionist, Sue, found my carefully considered, quite legible prescription wadded up in our waiting room wastebasket. In chronic illnesses like diabetes and hypertension, rates of adherence (continuing to take your medications fairly regularly) fall precipitously after six months of therapy, commonly to levels of 50 percent or so.
Why should we care? Often, the physician is in the dark about his/her patients’ compliance with medication taking; and as patients we want to please our doc, so we are often than less than forthcoming about our medicine-taking behavior. Plus, we spend a lot of time and money seeking medical advice and then totally ignore the pricey recommendations.
WHY DON’T PATIENTS TAKE PRESCRIBED MEDS?
1) The medication regimen is too complex — multiple medications, several times a day, “on an empty stomach and not within two hours of another medication.”
2) Medications are too expensive. Even though 85 percent of commonly prescribed drugs are available as generics, a handful of generic medications can add up to $200-$300 per month. The monthly dilemma of deciding whether to refill your prescriptions or pay the light bill is a common phenomena in the Grand Valley.
3) Patients may not feel that the medication is necessary or very important. We physicians may be at fault for not spending adequate time in explaining the importance of a new medication.
4) “This new medicine makes me sick. Until I started this medicine, I never had any problem with headaches, nausea, erections, rashes, hot flashes …”
WHAT’S YOUR ROLE AS A PATIENT
First and foremost, be open with your physician. If you cannot afford the medicine, tell your doc. Ask if there is a less expensive alternative. If you do not understand how to take the new prescription, or more importantly why you are taking the medicine, let your physician know. Perhaps your physician can simplify your three or four times a day dosing to once or twice a day. Set the alarm on your smart phone as a reminder. It is critical that you understand the specifics of why you are taking each of your medications. If your new prescription makes you sick, don’t just stop the drug, but also call your physician.
Finally, play an active role in your care. Ask,”Do I really need this medicine?” Take your up-to-date medication list to every physician visit and be certain your doc knows exactly what you’re taking.
GJ Free Press health columnist Dr. Mohler has practiced family medicine in Grand Junction for 39 years. He has a particular interest in pharmaceutical education. Phil works part-time for both Primary Care Partners and Rocky Mountain Health Plans. Email him at firstname.lastname@example.org.
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