How to help ensure patients take medications as advised

June 26, 2013 

Attention all physicians and pharmacies. The No. 1 healthcare problem in the country is medication noncompliance.

Annually, 125,000 seniors die and up to $256 billion is spent on unnecessary medical care, such as ER visits, hospital admissions, etc.

Patients and families are traumatized unnecessarily, both physically and emotionally, by complications of not taking their medications as prescribed. Fifty percent of the seniors are not filling their prescriptions.

According to a quote from Hippocrates, the Father of Medicine, this problem has existed for over 2000 years. Isn't it time we do something? This is just one part of the problem of medication noncompliance but we have to start somewhere.

There are solutions to this part of the problem. Let's start here and now. I have seen lots of research being done on this topic. However, someone has to take action. People are dying! Our country is in a budget crisis and we are spending hundreds of billions on unnecessary medical care.

These are my recommendations:

Physicians: Fax all prescriptions to the pharmacies. Many physicians are already doing this.

Have patients sign a "commitment statement" that says patients will take their medications as prescribed or notify their physician why they are not taking them. Have patients buy medications from one pharmacy of their choice. Using one pharmacy is the only way to prevent patients from taking medications that are not compatible. Also it is the only way a physician can know the patient is noncompliant unless the patient tells them. The "commitment statement" is to impress the importance of taking medication as prescribed. Physicians must have accurate information to treat patients appropriately. Patients need to follow all physician's instructions if they want to get better.

Pharmacy: I realize you will need corporate approval. Before returning medications to the shelves, notify the ordering physician.

Revise policies about holding medications. Hold the medication five more working days so physicians can interact with patients before returning medication to the shelves -- to avoid double work for you.

Revise all your reminder calls to pick up medications to include the following: "if medications are not picked up, your physician will be notified. You are responsible for telling your physician why you are not taking your medication as soon as possible. Don't put your health at risk."

Repetition is a good tool to increase compliance. Several researchers have found that physicians and pharmacists engaging in ongoing, compliance-improving education, based on individual patient's needs, is the single best intervention for noncompliant behavior.

If you agree with this letter, encourage your physician and pharmacy to participate and tell your friends, too.

I would appreciate receiving an email at if you are going to participate so I can evaluate if we are making an impact on this dilemma.

Kris Hendrix, RN, Retired


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