Why Don’t Patients Take Their Medications?

Written by Nihar Patel DPT'22, MBA'22
Published on October 24, 2018

With soaring medication non-adherence rates it is pertinent to look at the most common reasons for non-adherence in the general population. Research shows that approximately 25% of prescriptions are left unfilled by patients and nearly 50% of patients are non-adherent to the medication once they have obtained it.  The most common reasons for patient non-compliance to medications are intentional and include: high drug costs, fear of adverse events, being prescribed multiple medications, and experiencing either instant relief or medication ineffectiveness leading to self-discontinuation of medications.

One of the primary reasons for medication non-adherence as noted by the American Medical Association is fear. Patients are afraid of experiencing adverse effects of medications. This issue can be resolved if the patient has proper communication with their healthcare provider regarding their fears. The physician and pharmacist will clearly communicate all of the probable side effects of the drug, and/or prescribe an alternative medication. Another reason for patient non-adherence is having to take more than one medication. The more medications a patient has to take and the higher the frequency of the doses, the more difficult it is for them to keep up with their medication regimen. Educating the patient on when to take their medications and encouraging the use of pill boxes and phone reminders can help to improve adherence rates. The next reason for patient non-adherence is a patient experiencing instant relief or ineffectiveness from the medication. This can be avoided if the physician educates the patient on the importance of completing the prescribed treatment regimen, regardless of how they feel. A common reason for patient non-adherence is the high cost of medications. In this situation, the patient may not be able to purchase the drug as often as the prescription suggests, so they may decrease their dosage on their own. Physicians can prescribe a generic medication which is equally as effective and less costly. Additionally, utilizing GoodRx and other patient assistance programs can help decrease the cost burden of medications.

A common theme in the top reasons for patient non-compliance to medications is the prevalence of inadequate health literacy. As stated in Dr. Brown and Dr. Bussell’s research, close to 90 million Americans have inadequate health literacy. Inadequate health literacy influences the patient’s attitudes and beliefs toward taking their prescriptions and their interest in adhering to those medications. It is the responsibility of all health care professionals to be aware of the prevalence of medication non-adherence and to educate patients about the course of the treatment and the medications prescribed. Sufficient communication with the physician may result in the patient’s increased awareness of the generics available to them at lower costs, the expected side effects of the medications, the importance of completing the treatment of the drug, and ways to adhere to multiple medications at the same time. The increased knowledge a patient has about the course of treatment will result in a positive attitude towards taking medications and will in turn increase medication adherence rates.

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