‘Medical Non-Compliance’ is the failure to take medication according to the doctor’s prescription, or not at all. While most non-complaints are aware of the treatment benefits of accurately following their medical prescriptions, a large majority will discipline to skip, reduce or halt their medication without notifying their healthcare specialists, resulting in serious, and possibly fatal complications; marking it as a rising national and global epidemic.
While a significant number of individuals simply suffer from a lack of appropriate education; the confusion associated with taking multiple medications at different times, high costs that result in either self-reduction of the prescribed dosage to make it last longer or not buying it at all, unpleasant side-effects, misperceptions regarding a medicine’s ‘addictiveness’ and effectiveness, or simple forgetfulness are some common reasons for non-compliance.
Moreover, prescription complexity is also an important factor that stems from the lack of patient-doctor communication due to socially instilled beliefs of not questioning medical professionals. For instance, a prescription might say to take a certain pill ‘every 8 hours’, that can either mean ‘every 8 waking hours’ (twice a day) or the general 24-hours (thrice a day), hence greatly affecting the daily dosage.
Apart from treatment failure, non-compliance has a negative effect on both health and finances.
1- Not Following The Prescription:
Skipping doses, taking less than the prescribed quantity, or not buying certain drugs without informing the doctor fails to improve the condition and also interferes with the doctor’s attempts at proper treatment, leading to the prescription of a higher dosage or another drug; soon running out of treatment options.
Moreover, not taking a certain medication might also lead to life-threatening consequences. For instance, administering a diabetic patient hospitalized for infection with what the doctor presumes to be the ‘prescribed’ dose-which the patient never actually took-might actually be an overdose resulting in a low blood sugar induced coma.
2- Abruptly Stopping Medication:
Improvement of a condition or stabilization of symptoms (in case of long-term treatment) can prompt people to stop mid-course or self-reduce the dosage, which can often worsen the condition, decrease productivity, added expenses via increased doctor visits and higher-grade medication, hospitalization and even, death.
In the case of antibiotics and HIV medication, failure to comply can result in a rebound infection and medication resistance, making them difficult to cure and reducing treatment options, particularly for HIV drugs.
3- Mounting Costs:
Since most bacteria and other causative factors become resistant to the current medication due to incomplete or inconsistent courses and reduced doses, stronger, other, stronger medications must be prescribed to overcome this resistance, which is often more expensive than the initial, or ‘first-line’ drug.
Since a large majority of non-compliance cases result from involuntary factors, the following measures might help in prescriptive regulation:
- Sometimes doctors prescribe expensive brand-name medications, but their generic counterparts are just as effective and much more affordable, so discuss the possibilities of medication replacement with your doctor in case of cost issues.
- If unpleasant side-effects are the culprit, talk to your doctor about alternative solutions, as different drugs for the same condition often have different side-effects. Also, communicate with your doctor about any prescription-related queries you might have.
- Incorporate your medication into your daily routine, like putting morning pills next to your bed or mealtime medications on the table and take it at the same time every day.
- Make and carry a list of all medications and their required doses in case of multiple prescriptions, noting each time you take a dose in a special ‘medicine calendar’.
- Set alarms for all medication times or ask friends and family to remind you.
- Use a labeled, sectioned pill container to avoid confusion.
- Bring extra medication when you’re traveling, and if you’re flying, keep your medicines in your hand-carry baggage as temperatures in the cargo hold may damage them.
- Keep backup supplies at your workplace and in your bags.
- Do not save unfinished antibiotics for future use and don’t share with others.
The Providers’ Role:
Doctors can also improve the compliance rate by the carefully communicating prescription requirements and proper usage. They should also explain the medications’ purpose and consequences of non-compliance. Pharmacists can also contribute by helping people understand how to take their medication and suggesting reminder-products like pill boxes to ensure a timely dosage.
Medical non-compliance can be easily reduced with a little effort on the part of both patients and healthcare providers. If you have questions regarding your current medication, we suggest you consult a medical specialist and get a professional advice.