“Doctor’s orders” is a cliché for doing something, no matter what the objections might be, because it’s necessary for health or life. So, it’s astounding that 30% of Americans are not following their doctor’s instructions on prescription medication, and 50% don’t follow their advice on long-term treatments for chronic conditions like diabetes and heart disease.
Two of the main reasons are costs and memory. As we age, we tend to need more prescription medications and more long-term treatments. As the number of prescriptions increases, it gets harder to remember when to take which one — morning, evening, with a meal, between meals, once, twice, or three times a day. It’s even worse for older seniors with some cognitive decline.
Others are worried about potential side-effects, a concern that increases with age and the number of prescriptions. Some people worry about taking combinations of medications.
However, a more disturbing reason is that many people take less medication than prescribed because of the cost. Some do not see the cost-benefit — that is, they don’t think the health effects are worth the cost of the medication. But many others just cannot afford the cost of the drug. Too often, people have to choose between medicine and food. Some 2 million Americans on Medicare don’t take all their medications because they cannot afford them. So, they cut their pills in half or take their prescriptions every second day.
This endangers their health and actually adds to the cost — as much as $290 billion in avoidable healthcare costs in the U.S.
Effects on health
According to a study in the U.S., people who avoid or limit their prescription medication account for 20% of hospital stays and 25% of admissions to nursing homes.
It’s important to understand what happens when you don’t take medication as directed.
When your doctor prescribes medication for an infection, for example, they balance the amount of drug needed to clear up the bacteria, without giving you so much that it causes toxic side effects, taking into account how long it takes the medication to take effect and how quickly your liver or kidneys will eliminate it.
If you stop taking your prescription because your symptoms have cleared up but there are still doses left, the drug could have reduced the number of bacteria in your system below the level that causes symptoms but left some. When you stop taking the medication, the surviving bacteria can multiply and bring back even stronger symptoms. Worse, the bacteria that survive may develop antibiotic resistance, which means that resuming the antibiotic will not be effective.
Doctors prescribe some medications to prevent illness. For example, aspirin is often prescribed to prevent heart disease and stroke. Folic acid is often prescribed to pregnant women to avoid birth defects. For these to be effective, they have to be taken as directed, every day.
Take only your medication
By the same token, you should only take medications prescribed to you by your doctor, and never someone else’s, even if they’re a close family member with the same symptoms you have.
Some people are not good candidates for certain medications because of possible allergies or other contraindications. For some people, a particular drug for one condition could make another, unrelated illness worse.
Timing medications
Not only how frequently, but when in the day or week you take medications is also important. With some, it’s important to take them with food to reduce stomach upset. Others have to reach an empty stomach to be effective, so first thing in the morning, before breakfast, is the best time.
Your doctor may also advise you to take different medications at different times to avoid interactions between them, or to take them early to avoid interference with medical tests or other procedures.
Solutions
If cost is one factor that causes you to consider limiting your medications, ask your doctor or pharmacist for lower-cost alternative medications. Often, so-called “generic” alternatives are much less expensive.
If you’re worried about possible side effects, or problems resulting from combinations, communication is again the key. Talk with your health care provider and your pharmacist. To make informed decisions, you need all the information you can get. Write down the answers to your questions or bring a trusted friend or family member along with you to help make sure you’re clear on the information.
With some chronic issues, lifestyle adjustments can help reduce your need for certain medications. A healthy diet and regular physical activity make great differences in many health conditions.
If it’s remembering when and how to take your prescriptions, enlist others to help.
Set up a simplified regimen for taking medications. For example, you could decide to take all your prescriptions with breakfast in the morning. Talk with your doctor and pharmacist to make sure all your prescriptions are suited for this.
You can also set up a daily schedule, where you take certain medication upon waking, others with meals or before bed.
Your pharmacist can provide a daily dispenser marked with the days of the week to make it easier to keep track. Some larger dispensers have separate compartments for different times of the day. Some pharmacists will put your pills into the right compartments for you.
Involve family and friends to remind you to take your medications and refill prescriptions. Some pharmacies can set up automatic refills and deliveries to your door.
And remember that you can reach out to the friendly advisors at Health Choice One about your choices in medical and drug coverage.