When it comes to medication adherence, the bottom line was well summed up by the former Surgeon General C. Everett Koop when he said: “Drugs don’t work in patients who don’t take them.” If someone is sick, why wouldn’t they take their medication? It turns out the reasons are varied and complex for patients not following a treatment plan to the letter, ranging from complex treatments that are difficult to understand, a desire to avoid side effects, the cost of medications, or simple forgetfulness.
Asthma treatment is known to have a low rate of medication adherence. Finding ways to improve patient compliance could be useful not only for asthma patients, but also those strategies could also be applied to other health conditions.
A new study in the Journal of General Internal Medicine took a look at the medication habits of 358 older asthma patients who were prescribed inhaled corticosteroids and discovered that only 37% could be considered to have good adherence. The ways that the patients reported they tried to improve their medication adherence included:
- Linking medication use with another daily routine
- Storing the medication in one location
- Taking medication at a specific time
- Taking the medication at the same time as another needed medication
- Taking the medication when it was needed
Unfortunately, not all of these methods ended up being particularly effective for this group of patients, with the exception of the first one. Those who made the medication use part of their daily routine were nearly four times more likely to be one of the patients in the “good adherence” category.
A few demographic factors served as additional challenges to medication adherence, making it harder for the patients to faithfully take their medication, including: low income, being in generally poor health, depression, anxiety, poor understanding of their disease, poor English skills, and a low level of health literacy.
One final tidbit of interest was reported in this study. While the bedside table was the most common place for medication to be stored (one in five people did this), adherence was actually 3.1 times better in patients who kept their medication in the bathroom. Although there is a trade-off that the bathroom’s heat and humidity could degrade medications long-term, this is generally not a problem if you only keep a small supply there for immediate use. (If you have a larger supply of your medication, you can store it elsewhere until it’s needed.)
The take-away from this study – and what I personally do, as well as telling our patients to do – is this: make medication use a part of your daily schedule and store a month’s worth of your medications in the bathroom for immediate use.
Stephen C. Vogt, Pharm.D.
President and CEO
BioPlus Specialty Pharmacy
What do you think?
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Brooks TL, Leventhal H, Wolf MS, et al. Strategies used by older adults with asthma for adherence to inhaled corticosteroids. J Gen Int Med August 2014 DOI: 10.1007/s11606-014-2940-8.