We all know about the rising costs of health care, and how expensive prescription medicines can be, especially for seniors. But do you know how much it can cost if you don’t properly take your medications?
According to government estimates, each year in the United States more than 125,000 people die from a failure to properly take their medications, adding approximately $100 billion in preventable additional hospitalization, emergency room, and repeat physician visit costs to the health care system. At least 10% of all hospital admissions are a result of this problem. For seniors, the statistics are particularly alarming:
- Up to 23% of nursing home admissions may be due to an elderly person’s inability to self-manage her prescription medications at home.
- Over 21% of all drug-related health complications are caused by patients failing to adhere to their medication regimens, whether by accident, negligence, or intent.
- Up to 58% of all seniors make some kind of error when taking their medications, with 26% making mistakes with potentially serious consequences.
- In studies of elderly patients on long-term cholesterol-lowering statin therapy, researchers found that 57% had stopped taking them after 6 months, and 74% had stopped by the end of five years.
There are lots of reasons why people neglect to take their drugs properly. The most common reason is that they just forget, which seems innocent enough. The average senior takes about seven different medications (both prescribed and over-the-counter) every day, so it’s little wonder that it can be difficult to remember and keep track of them.
Numerous devices and strategies have been developed to help seniors keep track of their medications. You can find some of the relatively inexpensive “reminding gadgets” at your local drugstore, devices that help you organize your pills and/or remind you when to take them with visual and sounding alarms. You can also find very sophisticated reminding/dispensing systems that can cost hundreds of dollars, as well as services that will telephone you to remind you. Even the drug companies themselves are getting into the act, as some have set up free programs in which company representatives, usually a nurse, will contact patients who are taking their proprietary brands of medications and encourage them to finish and refill their prescriptions.
It always helps to have a caregiver present who can ensure that someone is taking his prescriptions on time and on dose, but that’s not always possible. Some retirement communities and most assisted living communities provide senior living with medications management as a service to their residents, which may be a good option for those who don’t have family members nearby to check on them for their medications (among other things). But even the best care and the most vigilant monitoring will be undermined if the patient himself is not willing to take the medications.
NONCOMPLIANCE & PATIENT EDUCATION
You might find it strange or foolish that someone would intentionally disregard the importance of taking medications, and yet it’s a common problem. For example, people may think that they feel better and discontinue treatment prematurely. Or perhaps the medicine doesn’t seem to have an immediate effect so they decide it’s not working and stop. Or perhaps it seems to work very well so they decide to take more of it per dose, or the prescribed dose more often. Or they stop because there may be bothersome side effects that they don’t like, or because they just don’t really believe that they actually need the medications. Or they may find the costs too burdensome and try to “save” the medication by taking it less often. Do any of the above examples describe your situation or that of your loved one?
The reasons for “noncompliance” (as it’s known in the medical world) can be as varied and individual as each patient, but when people willfully change their dosages or discontinue their medications, it’s usually not because they’re uncooperative or “just stubborn.” Instead, it’s usually because they don’t fully understand how the medications work and what the health consequences are when you don’t follow the regimen correctly or discontinue it altogether.
Patient education is not as simple as it sounds, because the responsibility lies as much with the patient as with the healthcare professional. People need to become more actively involved with their own healthcare, but that doesn’t mean deciding things on their own based on erroneous beliefs or limited information. What will make a difference is proper communication of all your questions and concerns when a doctor prescribes something for you. Don’t just wait for the doctor to tell you how and when to take it, because they won’t always tell you everything you need to know. Here’s a short list of basic questions to always ask:
- What is this medication called?
- How does it work?
- What are the possible side effects?
- Exactly how many times do I take this every day and at what intervals?
- Are there any dangerous interactions with other drugs or with certain foods?
- How long do I have to take this?
- How do I store it?
- How much does it cost (with or without insurance)?
People are often reluctant to demand a detailed explanation of their medication regimen for various reasons. They may be afraid of appearing pushy, or of questioning the doctor’s authority. Or they may be afraid of appearing uneducated or unsophisticated. Or they may still be mentally processing the diagnosis (which they may have just received a few minutes before) and are filled with anxiety. All of these are understandable and reasonable fears, but it may help to either call the doctor (or the nurse who works with the doctor) afterward so that your questions can be answered.
The importance of taking medications properly cannot be overemphasized, because the consequences of not following a prescribed medication regimen are especially serious for seniors, but it’s not just about possibly losing one’s life because of drug complications or mistakes. With each hospitalization and emergency room visit that may happen as a result of the resulting declining health, the risk of being prematurely forced into a nursing home increases. And that can cause the loss of something every senior would like to keep for as long as possible-one’s independence.
Update: January 2018