Key takeaways

Medication nonadherence, estimated to cause around 100,000 deaths and $100 billion in medical costs yearly, is often due to factors like high costs, low health literacy, side effects, and the complexity of medication schedules.
Educating patients about their medications, including how to take them, their benefits, and side effects, is crucial in addressing medication nonadherence.
Building trust and rapport between healthcare providers and patients encourages medication adherence by making patients feel empowered and part of their healthcare team.
Creating and executing a personalized action plan, which could include strategies like medication synchronization and the use of pill boxes or reminders, is essential in managing medication nonadherence.

Prescription medications are only effective when taken as prescribed. For many patients, however, taking medications may come with costs and inconveniences, such as money and time off from work to visit a doctor. But what’s the cost of not taking medications, especially those needed to treat chronic health conditions? The answer is worsening symptoms, hospitalization, and even death.

Medication nonadherence or medication noncompliance is estimated to cause around 100,000 deaths and $100 billion in medical costs each year. However, these consequences are entirely preventable.

Nonadherence to medication has many causes that can span different areas for patients, including high costs, thoughts and perceptions of healthcare, and behavioral changes. Pharmacists, doctors, and other members of the healthcare team can make a difference in helping patients take their medications correctly. Every touch point with a patient is a chance to identify any problems with medication adherence and fix the root of the problem.

Continue reading to learn more about dealing with medication nonadherence in patients.

Reasons for medication nonadherence

There may be a number of reasons why patients don’t take their medications. Here are some of the most common reasons that patients don’t keep up with their medications.

Lack of understanding

Due to low health literacy, many patients might not understand many aspects of taking their medication. Patients might not understand the instructions for taking the medication, what a specific medication is for, and the possible side effects of the medication. For example, a patient who doesn’t experience symptoms of hypertension might feel like they don’t need to take their medication. One study found that low health literacy may be linked to uncontrolled hypertension in some patients. Educating patients on their medications is key to addressing this issue.

Cost

The high cost of medications may be another cause of medication nonadherence. Patients may skip doses, take fewer medications, or delay filling a prescription to save money on their prescriptions. Patients younger than 65, especially those in families with low incomes or without health insurance, have three-fold higher rates of medication nonadherence due to high drug costs. Prescribing generics or assisting patients with savings options can be an option.

Side effects

Some patients may skip taking a particular medication due to side effects. Patients who experience side effects might not mention these side effects to their healthcare provider, which may lead to worsened medication nonadherence. Studies have found that side effects of mood stabilizers are a major factor in medication nonadherence in patients with bipolar disorder. Educating patients about side effects or switching to a new drug may help manage this cause of nonadherence.

Too many medications

Taking several medications on different schedules can be a burden for many patients with chronic health conditions. The need to take several medications can be overwhelming for these patients. Healthcare providers can address this problem by prescribing long-acting drugs that only need to be taken once daily. Helping the patient create an effective medication schedule and recommending tools like pill boxes and medication dose reminders can also be effective.

How to deal with medication nonadherence

Dealing with medication nonadherence can be a frustrating part of treating patients. However, the responsibility to address medication nonadherence often lies with pharmacists and healthcare providers.

Why don’t patients take their medications?

As mentioned, there are a number of possibilities for why patients don’t take their medications. Gently probing into the reasons for medication nonadherence may help identify a particular reason. Try going over each medication a patient takes to understand how each medication works for them. Ask the patient what they know about their current medications to help identify a lack of understanding as a cause of medication nonadherence. Pharmacists can also promote medication therapy management (MTM) sessions to patients to identify possible barriers to treatment.

Build trust and rapport

Building trust and rapport with patients can help them feel empowered and a part of the healthcare team. Patients may also feel more motivated to take their medications if they have a good relationship with their provider. Increased patient engagement can play an important role in identifying potential medication nonadherence risks and coming up with a personalized plan. Pharmacists, in particular, may be able to have meaningful interactions with patients more often than doctors.

Create and execute an action plan

Once any barriers to medication treatments have been identified, it’s time to create a personalized plan for the patient and execute it. The plan should be personalized to the specific issues the patient is having. For patients who have trouble getting to the pharmacy to pick up their medications, synchronizing their medications can be an option. Medication synchronization involves arranging for all medications to be filled and picked up on the same day to prevent the patient from having to come on separate days to pick up different medications. Other strategies for medication adherence include educating the patient about their medications, promoting the use of pill boxes or reminders, and informing patients about potential savings options for their medications.