I’ve lost three old friends over the years when they refused to have medical treatment for serious health conditions.
One had a treatable form of breast cancer but believed a conspiracy theory: Doctors had cured cancer with a natural remedy, and Big Pharma had hidden this from the public.
She followed the advice of a local herbal salesperson and died six months later.
Another friend died by suicide after he stopped taking his medication for severe depression because it caused erectile dysfunction.
Another died too early when he wasn’t treated for diabetes because he didn’t have insurance and was out of a job.
The American College of Preventive Medicine found nonadherence to medical advice is prevalent, with deadly consequences: It accounted for an estimated 125,000 deaths annually and at least 10% of hospitalizations.
The contributing factors to not taking prescribed medications may be a combination of a lack of understanding of the drugs’ benefits, a lack of resources or insurance, the unpleasant side effects, and a rejection by the patient for religious or personal reasons.
The failure of individuals with schizophrenia and bipolar disorder to take prescribed medications is one of the most serious problems in psychiatric care. It often leads to a relapse of symptoms, rehospitalizations, homelessness, incarceration in jail or prison, victimization or episodes of violence.
According to the Kessler Foundation, the majority of those not taking medications reported they did not believe they were sick.
Anosognosia is a neurological condition in which a person is unable to perceive or is unaware of his or her own illness.
Those who don’t adhere to their prescribed medications, according to the World Health Organization, have a reduced quality of life, disease progression, a shortened life span and increased health care costs.
Adherence is the extent to which patient behavior aligns with clinical decisions that were mutually decided upon by the patient and provider.
In contrast to compliance, adherence encompasses patient freedom of choice and does not blame the patient for nonadherence.
Researchers at John Hopkins University have found poor patient-provider communication is another source of nonadherence to medical advice. They recommended doctors explain the purpose of the medication and the likelihood the medication will resolve the health problem.
Other significant influences on nonadherence included the high cost of medication, a lack of insurance coverage and the restrictions on refilling a medication without returning to the doctors’ office.
If you don’t take a prescribed medication at the right dose, at the right time, in the right way and at the right frequency, there is little chance it will work to improve a health condition.
According to the Cleveland Clinic, 40% of resistant hypertension cases is caused by not taking medication correctly. The clinic stressed that in order for the drugs to work, they must be taken every day at the correct dose and the correct number of times per day.
The Centers for Disease Control and Prevention estimated nonadherence causes 30% to 50% of chronic disease treatment failures.
According to the CDC, up to 50% of patients being treated with statins, which lower cholesterol, stop taking their medication within one year and 20% to 30% of new prescriptions were never filled.
Tips that may help patients adhere to a doctor’s prescription:
- Take medication at the same time every day and keep a log if needed.
- Take medications when getting ready for bed or after eating breakfast, depending on whether the medication should be taken on a full or empty stomach.
- Prepare a pill box with seven days worth of each medication, place it in a plastic bag over the container so it doesn’t spill accidentally.
- Ask your doctor or pharmacist to explain the medication benefits and side effects.
- If you have concerns about the side effects, ask your doctor what is available to alleviate them.
- Prepare for travel in advance by organizing medications for the trip. Keep the medications with you in a carry-on bag when you fly.