Claire is an English teacher in a high school. She juggles her life with her work and her two children. She often misses her meals, is disconnected from her friends, and has little time to herself, always trying to make ends meet. At the age of 37, she was diagnosed with hypothyroidism; a thyroid disease which requires lifelong medication if she is to remain well. Amidst all the hustle and chaos in her life, she tries to take her medication on time but often misses her pills here and there.
Like Claire, many people cannot take their medicines on time. Be it workload, lack of time, constant every day distraction or difficulty getting to the pharmacists, a considerable amount of the population cannot stick to the medicinal prescription for their disease.
Understanding how medicines work
Pharmacokinetics is the study of how the body interacts with a drug. It includes measuring the duration for which a certain amount of medication is present in the body and how the body metabolises and eliminates the drug. Pharmacodynamics looks at how the medication affects functions of the body. Based on this, a doctor prescribes the dose of a medicine and frequency at which the medication is to be administered. Lack of adherence to the doses on time means you do not get the desired effects of the drug on your body, which can lead to inappropriate dose escalation. Poor timing and dose escalation can also increase the likelihood of side effects, setting up a vicious cycle.
Importance of patient compliance
Patient compliance is the patient's behaviour towards the healthcare prescription provided by the doctor. It is when a patient takes their drug on time and sticks to the routine of medicine administration as advised by the medical professional. Patient adherence is the single most significant factor determining the success of a medicinal treatment. A patient is considered adherent if they take 80% of the prescribed medicines on time, but in reality patient will get greater benefit the closer they get to 100% compliance.
Risks associated with non-adherence
There are many risks associated with non-adherence. Such as symptom break through, which leads to millions of unnecessary visits to the ED and hospitalisations and deaths, the dangers of accidental intake of unused medication, bacterial or microbial resistance to a drug not taken as per the protocol, and physiological effects on the body such as diarrhoea, liver problem, or fatigue.
The concept of population immunity is based on the premise that a population is said to be immune to a disease if most (but not all) healthy people with the population have immunity to the disease. This is called herd immunity. The increasing number of people becoming prone to an illness will automatically cause the population to be prone to the disease. It is possible to eradicate any disease only if most of the population is immune to it.
What could be the reasons behind resistance to taking medicines?
The reasons behind poor adherence with medication programs are complex and can include psychological, cognitive, financial, societal factors, or an amalgamation of any or all for an individual. Let's discuss a few significant factors,
Memory, Cognitive and lifestyle changes
A significant cause of poor adherence can lead to memory or cognitive impairment. This can be readily understood, as the burden of disease and the associated medication use increase as we age, while our cognitive abilities and, perhaps just as importantly, the routines we lose as we retire, mean that it becomes harder to remember to take all of the medication needed at the right time. In fact, in larger surveys, up to three quarters of non-adherence is observed in patient aged over 65, can be attributed to forgetting to take their medications.
Lack of patient understanding
Very often, patients do not understand the drug action or are unaware of the potential risks of incorrect medication administration. An overdose of antihypertensive medication may lead to patients fainting and suffering trauma as they pass out. An underdose or late dose of a medicine can render the entire treatment unsuccessful because the doses are adjusted to impact our bodily functions in a particular way by taking a particular dose at the right time. Poor adherence is a key reason for medication “failure”, which can lead to unnecessary dose escalation and then associated side effects.
Individual beliefs on medications
Rumours travel faster than a forest fire, and in today's age of the internet, it's child's play to write a post or share a message with false claims and false reports disguised as news. Consumer awareness still needs to improve despite the free access to information databases online to crosscheck a false claim regarding medications.
People can believe such rumour, which then leads to medication avoidance. A perfect example is the latest pandemic situation, where vaccines were the source of many unfounded rumours. It is crucial to always talk to your medical professional and get assistance on such beliefs or clear your doubts about the prescribed medications, rather than reading poorly informed and anonymised blog posts, to ensure that if you decide to discontinue with treatment, you are clear on the risks and benefits.
Improper tracking of medication administration
Each of us has a hectic life, just like Claire did at the beginning of this blog, and we can all relate to missing a dosage or losing track of the medicine dose now and then. Improper tracking of meds can cause a doubled dosing of the medicine or lead to skipping of a dose; either way, it causes poor adherence to treatment. You can ask your medical professionals for clinical support and find solutions to tracking your medicines in a timely and hassle freeway. We have mentioned solutions to the medicine tracking problem below, keep reading, and you will get there.
Poor engagement and trust with healthcare providers
Often, healthcare providers and medical professionals fail to communicate effectively with patients. One of the most common causes is lack of time, which leads to poor doctor-patient interactions and decreased patient trust towards medical professionals.
A successful healthcare system needs patients who trust the system and professionals who ensure a good experience in the healthcare centres. Less trust makes patients feel less connected with the professionals. It gives room for doubt regarding prescription and introduces hesitancy when they need clarification on some subject, including medications.
PS - For many patients across the globe, the high cost of medicine is one of the most severe challenges faced by them. According to WHO, half the world is deprived of the necessary health services. At the same time, about 100 million suffer due to inadequate health care resources.
Okay. But how can we get on course with our prescription and treatment?
There are methods and tools suggested by medical professionals to tackle this issue of poor patient adherence to treatment. You can take note of a few highly recommended ones below.
Overcoming the communication gap with healthcare providers
A patient's health experience often revolves around their interaction with the healthcare providers. An unprofessional, rushed or rude interaction with the professionals can lead to a patient's distrust of the healthcare system and the medication protocol.
Likewise, patients should effectively communicate with healthcare professionals about their physical and mental turmoil, resolve their doubts, and learn the necessary information on the impending disease. This will help you build trust with the healthcare system, promote communication with the experts when a rumour persists and steer away from panicking after being diagnosed with a particular disease.
Understanding medicine and patient adherence
An extensive study indicates the patient adherence rate in developed countries can be as lows at 50%
Understanding the communication barrier between the patient's trust and the healthcare system, the next big task is to understand the importance of compliance with a treatment protocol. This includes awareness about the medicine's purpose, dosage, repercussions if the doses are skipped, side effects and when the medications should be stopped.
Conversations with a medical professional will help you dissipate the reluctance and bring more clarity to our goal: having a healthy long life.
Use of tracking tools
A benefit of living in the 21st century is the availability of tools and services to help you sustain your lifestyle in a hassle-free manner. Today there are many tools and equipment, such as monthly medicine boxes, automatic pill dispenser, mobile notification tools to remind you of your meds, and mHealth services to provide comprehensive support to your treatment schedule.
You can contact us if you are looking for a medication tracker, pill dispenser, or consultation services to automate your medication schedule.
Coherence offers the equipment and services to assist you or your concerned person's medication journey.
Understanding medication adherence and patient compliance to treatment is imperative. By communicating with your healthcare providers or medical professionals, you can develop a greater understanding of your medication and engage more fully in having a healthy and happy life. You can come to a solution which
solves your medication problem and actually enhances your buzzing lifestyle. t
Nevertheless, you may need assistance in navigating through your healthcare journey. In that case, you can reach out to us, and Coherence will be your med-journey partner.