As a child I was considered by many to be a sickly child; I visited the doctor regularly where I was poked and prodded repeatedly. I was given from tablets to injections, which may account for my present aversion to taking medicine. I am very sure this negative response to medicine is not unique to me, but rather, I would like to believe that there are many who share my aversion or even worse. The bottom line is, we all hate taking medications and would probably only feel the urgency or necessity to do so when illness forces us into a corner.{{more}}

Why is adherence important?

Treatment adherence means taking the correct dose of your medications every time, exactly as prescribed by your doctor or recommended by your pharmacist. Being non-compliant to medication is an extremely serious problem, because not taking medications means that people would not maintain their health; they would be at risk for more serious health problems; and they could further complicate their health concerns which the medications were meant to treat.

General considerations when prescribing medication to patients:

1. People generally do not enjoy or want to take medication. Taking medication forces the individual to admit that they are sick or that they are dependent on a medication in order to feel better. This is particularly true for chronic conditions that we have for a lifetime (for instance HIV) and for those that carry stigma, like mental illness. Every now and again we want to take a ‘med break’ to see if we have gotten better or if we really ‘need’ to take those drugs.

2. Side effects are often as problematic as the drugs themselves. One of the main side effects which can be problematic for a lot of people is weight gain. This is especially so for women, who may be concerned about gaining weight due to a medication, even if it means saving their lives. For the mentally ill patient, it is a battle of whether it is better for me to be ‘sane’ or functional and fat than a little not so ‘sane’, but maintaining a slim physique.

Not forgetting also, the risk of damage to kidneys and liver which some medications are known for. Throw in the regular blood tests to monitor organ function as a result of taking some drugs and the motivation to take them suddenly goes out the window. If someone needs to take medications for a side effect, their motivation to take the first medication can decrease.

3. Sometimes we forget. The reasons for this can be as simple as sleeping at a friend’s house and not bringing along a night’s worth of meds. Then you are told take this one without food and take that with food. Take this one four times a day and the other one three times a day and the other one at night and the other in the morning. Who has the time for all that? Let’s face it, taking medication can be tedious and requires a lot of effort to keep on track.

4. We don’t understand what the drugs do and therefore are not motivated to take them. Let’s acknowledge that a lot of medications work, but most of the time, doctors don’t take the time to explain how they work. That said, a patient who knows why they are taking a drug, how it works and why they need to take it is much more likely to take their medication than someone who was handed a prescription to fill, suffers some side effects and wonders what it is the drug is supposed to do. As a patient I would encourage you to take the time to research your medications and ask questions when in doubt.

Few benefits of being adherent:

1. Overall health improvement

2. Lower risk of adverse health outcomes associated with a lack of adherence

3. Patients who take their medication regularly are also more likely to perform other healthy behaviours, such as eating properly and exercising regularly.

4. Reduction in hospitalization.

Encouragement:

Be adherent and compliant to your medical regimen. Ask questions about medications and side effects; return to the doctor if you are realizing adverse side effects to the prescribed drugs. Seek support from family members or trusted friends who would ensure that you are taking your medication in the manner and time it should be taken.

To the medical practitioners, I would also encourage you to work more closely with your patients to educate them about their medications and to find ways to mediate the side effects and complicated drug regimens.

Perhaps the approach needs to be more holistic, where the focus is not merely about taking medications, but also about lifestyle changes as the key feature of treatment.

Prepared by:

Dr Jozelle Miller

Health Psychologist