Monday, Jun 18, 2018
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The medication puzzle

REMEMBER when your mother admonished you to "take your medicine" like a good little boy or girl? Many Americans, we're told, haven't paid attention to that advice, with consequences that are both costly and potentially deadly.

It has long been recognized that low or fixed-income patients sometimes stop taking prescribed medicines because they cannot afford both the medicine and basic necessities such as food, rent, or heat. It is also not uncommon for the elderly, who often have several prescriptions, each with its unique regimen, to become confused about what to take when and, therefore, to miss doses, over medicate themselves, or stop taking their drugs entirely.

Now, the National Council on Patient Information and Education says its research shows that neither poverty nor age nor education is sufficient to explain why folks can't take medicine correctly. For example, people without overt symptoms appear to have a hard time sticking to a drug regimen. Just 51 percent of high blood pressure patients - who have three times the risk of developing heart disease - stick to their prescribed medication.

The threat of living with the consequences of disease does not ensure compliance, either. Among glaucoma patients who had already lost their sight in one eye, only 58 percent were taking precautions to protect their other eye.

Neither are young people any better than their elders at taking their medicine. Among teenage asthma sufferers, only about 30 percent correctly take their drugs to prevent more attacks.

The reasons people do not take their medicines correctly, if they take them at all, are many. Among the most important is confusion created by the pile of paperwork and labels attached to prescriptions, all of it containing important information about the drug but often worded differently.

Then there are the bottles themselves. The National Council's research indicates that fully one-third of literate patients were confused by the instruction to "take two tablets twice daily." Does it mean take two tablets each day, or does it mean four? (The answer is four.)

The result is that, on average, half of all patients with chronic illnesses such as heart disease or asthma skip doses, take extra doses, or stop taking their medicine entirely, costing the health-care system billions of dollars in preventable illnesses, reducing the quality of life of thousands of people, and shortening the lives of others.

The solution is multilayered but simple in application. Doctors must take the time to explain to their patients, in unequivocally plain language, the "hows," "whys," and "if you don'ts" of their medications. Pharmacists should explain the same things, in the same plain English, at the time medications are dispensed. And labels should echo the previous instructions.

These simple steps would go a long way toward making sure that people get the appropriate medicines at the designated times, in the correct dosages.

As Mom always said, "There, now, that wasn't so bad, was it?"

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