Why do patients stop taking medications? I’ve spent a lot of time and effort working with patients to improve their drug therapy, but it really doesn’t matter if they don’t actually take the medication that is best for them. Here’s a list of the most common reasons that patients stop taking their medication(s). To be clear, this is a total anecdotal post from my experience.
Lack of benefit or lack of perceived benefit. In my experience, this is the number one reason why patients stop taking their medications. When using an antihypertensive or a hyperlipidemia medication, the patient is unlikely to notice any physical difference. When we manage chronic conditions that have no warning signs until something bad happens, it is difficult for patients sometimes to accept that studies and evidence is what we are going by.
Adverse effects. When a patient experiences adverse effects, they sometimes don’t report them. They just stop the medication that caused the issue and go on with their life. For some medications, this isn’t a big deal, but for others that are intended to prevent really bad things (i.e. stroke, heart attack, etc.) from happening, it can be catastrophic. Quick follow up within the first few weeks of therapy can help catch this to ensure that the patient is tolerating the medication. A review of symptoms can also help tease out potential adverse effects.
Cost. Paying attention to patients who are given initial discounts on brand name medications is important. I’ve seen coupons used in the short term, with no long term plan to pay for a chronic medication. I focus on the brand name and other expensive medications first but also pay attention to patient-specific factors that may be an issue (recent job loss, divorce, financial issues, etc.)
No trust with provider. When patients don’t feel heard and get a prescription thrown (figuratively) at them, they are less likely to trust the provider and hence take the medication.
Opinions of friends and family. Conversations amongst the lay public about medications happen all the time. In addition, really bad things can happen from medications. Anecdotal, negative stories from other patients who have taken the same can be really persuasive and instill fear in our patients even though they may be tolerating the same medication without issue.
Frequent dosing, scheduling issue. Dosing medications multiple times per day can interrupt a patient’s day. Many times patients will skip a midday dose for a TID medication.
Poorly educated/miscommunication. We fail periodically as healthcare professionals to ensure that the patient understands what they need to do with a medication. In addition, patient factors such as pain, infection, cognitive impairment can impact the benefit of any medication provided.
What else would you add to this list?
- 30 medication mistakes PDF
- 18+ Page Drug Interaction PDF
- 10 Commandments of Polypharmacy Webinar based on my experiences in clinical practice
Maybe this would be considered part of communication, but I think it should be a separate category. Overwhelm is a huge problem that I think many of us do not give enough credence. We are so used to all things medical, but patients receive a ton of information and not nearly enough time to process it. The antidote to this is for the pharmacist to have time to assess how much the patient knows and understands. Unfortunately, the vast number of retail pharmacists do not have this time.
Great list and good reminder to assess our patients for any of those reasons. Adding one to the list: They forget. A lot of elderly folks esp with cognitive decline need some sort of reminder system in place to remember some of their doses. Interviewing a family member and figuring out a system that works is important.