Ignoring prescription directions a huge issue

September 21, 2013

The day after Congress passed the Affordable Care Act in 2010, the American Society of Health-System Pharmacist published a legislative summary that concludes “… pharmacists must be prepared to lead the implementation efforts on the numerous medication-use-related aspects of the law.” This remains true today and will continue for as long as patients take prescription drugs, over-the-counter remedies and dietary supplements.

The buzzword surrounding this problem is “adherence,” which means making sure patients take the amount of medication prescribed by their health-care provider for the proper amount of time.

It sounds simple to have people take their drugs on time and in the dosages prescribed by their doctors. However, medication non-adherence is a serious problem in this country that is unhealthy, potentially lethal for patients and costly for our health-care system.

A recent poll conducted by GQR Research showed that “nearly two-thirds of people who take prescription medications are non-adherent, either by not taking their medication as prescribed or not at all,” which results in increased emergency room visits and hospital re-admissions. Not surprisingly, nearly two-thirds of physicians said medication adherence is a “top health issue,” according to a survey by eClincalWorks.

Every 90 minutes a patient dies because of an accidental overdose or missed prescription, and the U.S. wastes more than $300 billion annually on unnecessary medical costs that can be avoided by eliminating non-adherence.

When it comes to taking medicine for chronic conditions as prescribed, Americans earn a C+ on average and one in seven receive a failing grade, according to the National Community Pharmacists Association. B. Douglas Hoey, chief executive officer of the NCPA, said “anything less than an A on medication adherence is concerning. Poor adherence may be the most deadly, most costly and yet most preventable action that can make patients healthier.”

The most common form of non-adherence was missing a dose of a prescribed medication, reported by nearly six in 10 of those surveyed. Thirty percent reported forgetting whether they had taken their medication and 28 percent said they failed to refill a prescription on time.

About two in 10 said they have taken a lower dose than instructed or did not even fill a new prescription, and 14 percent admitted to going off their medication without consulting their physician.

It’s clear then that pharmacists have a vital role in stressing the importance of taking medications as prescribed, in monitoring and helping patients avoid or reduce unpleasant adverse effects that may compromise adherence and in helping keep patients better-informed about their health conditions.

According to a national survey, the biggest predictor of medication adherence was patients’ personal connection with a pharmacist or pharmacy staff.

“Patients of independent community pharmacies reported the highest level of personal connection,” the survey said.

For some, adherence may be a hard pill to swallow, but with major changes in health care to begin 2014, it may be the best way for you to improve your overall health, which can then result in a reduction of your current medication.

Mike Decinti can be reached at