Are you taking your meds?

Dr Douglas Street, Contributor

Most persons will go to the doctor at least once in their lifetime and will need medication to treat an illness or infection.

Some persons have long-term conditions, which need daily treatment; however, some persons don't bother to buy the medications, and even when they do, they are often not taken as prescribed, referred to as non-compliance.

Data from the United States indicate that 30 per cent of new prescriptions are not filled, and even one-fifth of new prescriptions for hypertension, diabetes, and high cholesterol are not filled.

Even when they are filled, only about 50 per cent of the doses of the medications is taken as prescribed in patients on long-term treatment. Only one-third of seniors prescribed hypertension and cholesterol medication were taking both at six months.

LOW COMPLIANCE

For patients on depression treatment, only three out of 10 patients were still on medication at six months. Even after a life-threatening complication such as a heart attack, compliance with medications after two years drops to about 50 per cent.

This non-compliance with treatment does have serious implications. Up to 70 per cent of drug-related adverse events that result in admission are related to poor compliance. Also, up to 40 per cent of nursing home admissions are related to poor adherence to medical treatment. Non-compliant hypertensive patients are 5.4 times more likely to be hospitalised, re-hospitalised, and die prematurely than compliant ones. For dyslipidaemia, the increase in risk is 2.8 times.

Some persons don't buy the medi-cation due to financial constraints. Sometimes the medications may be expensive or the person may just have very limited financial resources. This may be offset by accessing the medication through the public health care system or using reputable generic medications.

BEYOND COMFORT ZONE

At times, persons may be taking more medications than they are comfortable with. This may be due to their having a severe illness or one or more illness. In this case, using medication with less frequent dosing may help, e.g. using a once-daily medication rather than a three-times-daily one. Medications that offer a shorter course, for example, five days instead of 10, can also be utilised.

Stress (whether short or long term), depression, forgetfulness, ignorance and lack of motivation may also contribute to non-compliance. Education, empowerment, and good social support may help to improve compliance in these situations. Physical or mental disability may also affect compliance. Organising the doses of medication for the day or week often helps.

Dr Douglas Street is a general practitioner and has private practices at Trinity Medical Centre, Trinity Mall at 3 Barnett Street in Montego Bay, and Omega Medical Centre at Plaza de Negril, Negril. Send feedback to drdougstreet@yahoo.com.