To boost medication adherence, there are plenty of apps and products geared toward helping you remember to take your medications—from simple “days of the week” pill boxes to digital reminders, these prompts help those who struggle with medication schedules, especially if multiple medications are involved. But what if memory and organization aren’t the real issues for you? Although recalling medication instructions is an important part of adherence, that’s not the only reason people might feel challenged when sticking to a medication. Here are some other possibilities that you might experience:
Every medication has the risk of side effects, even over-the-counter options. The most common include nausea, fatigue, headache, muscle pains, and dizziness. While some may be mild, these and others may be bothersome enough to interfere with your daily life – interfering with your sleep, frequent urination, a foggy mind, tingling sensations, and others. When that happens, some people may stop taking their medications, or take them on a different schedule as directed, as a way to reduce side effects.
Maybe you’ve been on a medication for weeks and can’t tell if anything has changed about your condition. For example, you’re taking blood-pressure-lowering or cholesterol-lowering medication but you don’t feel any different. So, you might reason, what’s the point of staying on the medication or taking it every day if it doesn’t change the way you feel. It’ll probably still work, right?
It might seem surprising, but for some people medication usage can cause symptoms to worsen, which can be very frustrating. For example, you might be taking medications to control migraine frequency, only to have them start up more often than before, or change the type of pain you feel. Maybe you’ve been prescribed an anti-inflammatory for joint pain, but now that joint feels more inflamed than ever—and joints that were once fine are now affected, too. Maybe the pain medication for your back isn’t providing any relief. Situations like this often cause people to stop their medications because they might feel like they’re doing actual damage to their bodies by sticking with their medications.
If you’ve taken your medication as prescribed and your symptoms are gone, that’s likely a time when you feel like the medications did their job and you don’t need to finish the course of treatment as prescribed. For instance, some people might feel this way about antibiotics, even though doctors caution against stopping the medications when symptoms clear up and tell them to finish the full course.
Cost is a factor for many people, especially those who have high-deductible insurance, no insurance at all, or the medication that was prescribed isn’t covered. If you get sticker shock at the pharmacy, you have a higher risk of deciding not to take the medication. Or you might fill the prescription but “ration” the dosages to make the supply last longer, increasing the likelihood you’re not getting the benefit you need from the prescribed treatment.
Research suggests that the greater the number of different medications prescribed, and the higher the dosage frequency, the more likely someone is to be non-adherent. This may be because it’s too confusing or too much of a hassle to organize and schedule all those medications, or because drug interactions are causing side effects.
Balancing your day without medications can already be a difficult enough task. Add a medication, or multiple of them, multiple times per day, and you may get the directions right a handful of times per week. Many studies have shown that the more times per day you need to take your medications, the less likely you are to take them.
In addition to the many reasons listed that may cause you not to take your medications as prescribed, there are likely many others. If any of these sound familiar, it’s important to know that there are almost always alternatives available that can deal with your specific issue. It is important to inform your doctor or pharmacist about what’s happening and how it’s impacting your life. Then you can work together on finding medication(s) that work best for you and your lifestyle, not just for your symptoms or condition. When that happens, medication adherence is usually much easier.
When you’re starting a new medication, you might be told about the potential side effects by your doctor, pharmacist, or other healthcare provider. Even if they seem minor, it’s important to build some awareness around how you feel—physically, mentally, and emotionally—as you ease into taking your medications.
Here are key considerations to keep in mind about potential side effects:
Maybe you’re starting a pain medication that worked very well for a friend, and helped alleviate her symptoms. But for you? Not so much. The pain might still be there, and now you’ve got other issues, too, like headaches or nausea or constant dry mouth. Why are these new problems happening to you when they weren’t a factor for your friend?
The fact is, everybody has unique reactions to medications—good and bad. Medications are complex and our bodies are complex. That’s why there are usually multiple options for your condition, so that if you experience side effects or the medication isn’t working, you can try something else.
It’s also good to keep in mind that someone else’s side effects shouldn’t make you hesitant to try a medication that’s been prescribed. For example, just because your friend may have become nauseated by a particular medication doesn’t mean that you will, too.
You take a medication for migraines and a few days later, you have trouble concentrating at work, or feel pin-pricks on your hands or back, there are muscle spasms in your leg, or you feel anxious and irritable. Are those effects related to your medication or simply coincidental?
Pinpointing whether medication is causing changes in your mental, physical, or emotional state is a good topic for you and your doctor. But in the meantime, just be aware that there can be a variety of side effects caused by your medications, even if they aren’t the most common ones mentioned by your doctor or pharmacist.
Even if you’ve been taking a medication for a long time, new side effects can happen due to changes in your body. If you start to experience new symptoms, and you take medications, it’s always a good idea to inquire if these symptoms could be caused by one of the medications you’re taking. Often we don’t think of medications as the cause of a new problem, but medications are complex and our bodies are complex, so it’s important to make sure your health care provider considers this possibility.
There’s a reason medication instructions can be so, well, instructive. Take with meals, don’t take with meals, take every 12 hours, take at night, and so on. These directions are designed to increase the efficacy of how the medications work, and to limit side effects whenever possible.
For example, some pain medications may cause stomach upset or make people nauseous. Taking the dose with food may be an option to limit this side effect. Or, your blood pressure medication may make you use the bathroom more. Taking the dose in the morning can help prevent you waking up throughout the night to use the bathroom.
In addition, some drugs may work better depending on the time of day they are taken. For example, some cholesterol medication may work best if taken at night, the time of day when your body is making cholesterol.
Taking the time to jot down anything that feels new—even if it seems completely unrelated to your medical condition and treatment—can be useful for seeing whether you’re dealing with unexpected side effects.
Simply put, every medication has potential side effects. These can range from benign to life-threatening, and some effects are far more noticeable than others. That’s why it’s important to stay aware of changes while you’re on your medication, and let your doctor or pharmacist know what’s going on.
Always let them know every medication you’re taking, from every prescriber, including over-the-counter drugs, supplements, and herbals. That way, you can work together to adjust treatment, and possibly find a medication that addresses the same issue, without the same side effects.
Medications each have a variety of mechanisms of action, some well understood and others not, which is how they’re able to “target” specific systems or receptors in your body and provide you benefit. But even when they’re doing exactly what they’re supposed to, your medications may work even better with a little help from you.
What you eat and drink, how often you exercise, whether you get enough quality sleep, and how you handle stress or feeling depressed can all play a role in your health—and often, focusing on improving those behaviors can go a long way toward boosting a medication’s efficacy.
Remember that medications aren’t a replacement for lifestyle changes—we’re not quite at the point where you can reap the benefits of exercise and healthy eating through a prescription. Instead, medications are usually meant to complement healthier behavior and work together with your body in a meaningful way.
For instance, when your stressed and not getting enough sleep, your body’s ability to ward off or get rid of an infection is reduced. While medication may help reduce the infection in your system, if you don’t take the time to relax, rest, and sleep, the infection can come back or symptoms may linger longer than necessary. With better stress management and sleep your immune system improves, which can make your medication more helpful…or help prevent certain illnesses all together.
The ripple effect of lifestyle changes and enhancing the response to medications can create more benefits than you might think. For instance, consistent improvement in nutrition and activity may lead to better moods, less joint pain, clearer thinking, and a greater sense of resilience and wellness—outcomes that may not seem related to your medication and lifestyle changes at all, but result nonetheless as happy side effects of good behaviors.
Has your health care provider ever commented “Try to exercise more,” “It’s important to exercise regularly,” “Make sure to watch your diet,” or something along those lines? They say that to everyone, right?! While regular exercise and a healthy diet is good practice for everyone, there may be additional reasons WHY making the extra effort to change the amount you move and what you eat is important. Another major benefit of embarking on lifestyle changes is that you may be able to affect the amount or type of medication that you take.
For instance, for people who have high blood pressure, if they are able to lose some weight and reduce the amount of salt they consume, the dose of medication or even the total number of medications they take can be reduced —based on their doctors’ recommendations, of course. Making lifestyle changes can produce improvements in measures like weight, cholesterol numbers, body fat percentage, resting heart rate, and other markers.
The same is true for Type II Diabetes. Losing weight and improving what you eat can reduce the number or doses of medications needed to keep your blood sugar under control and delay complications related to the condition. One example is a diabetes medication like insulin. For some people, losing weight can improve the body’s response to insulin, which means less medication or, in some cases, eventually stopping it altogether if the doctor says it’s safe to scale back and discontinue use.
Even conditions that aren’t chronic can follow this path. For instance, you may be able to reduce use of pain medication if you can lower the amount of inflammation in your body through strategies like healthy eating, stretching, and exercise.
It’s important to work closely with your doctor if you’re making changes to your diet and exercise routine while taking medication. Because the dose you’re taking may start working even better, you’ll need to recognize the effects of a strong dose. In the examples of high blood pressure or diabetes, too much medication can cause your pressure to drop too low, making you dizzy or lightheaded, and increasing your risk of falling.
Making large-scale, wholesale changes to your life is never easy—there’s a reason why about 80% of New Year’s resolutions are abandoned by February. But the good news is that even smaller, incremental changes can add up to major benefits.
You can start by adding some vegetables to meals, walking during your lunch hour, and going to bed about seven to eight hours before your alarm. Even taking a few deep breaths every hour has been shown to have a big advantage for de-stressing.
If you’re taking medications for Type II Diabetes, high blood pressure or cholesterol, and even your mood, small changes in your diet, exercise routine, and time to relax, can really compliment the purpose of your medications.
Most patients feel that time crunch that comes with doctor visits—as soon as the physician walks through the exam room door, the imaginary stopwatch begins.
According to the National Institutes for Health, the average primary care office visit is about 17 minutes, and an average of 6.5 topics are brought up during that time, giving less than 2 minutes of focus per topic.
You may experience more or less time with your health care provider, and it may not be as short when visiting a specialist, but it certainly highlights the need to be as efficient as possible in addressing your needs, getting your questions answered, and communicating important health info like medication side effects or making sure your medications are still working or needed.
Here are five strategies for making your next visit more effective:
Keep a running list of questions in a notebook or on your phone so you can add to it for at least a few days before your visit. If your list is way too long to cover in one visit, let the doctor’s office know that you’d like a longer appointment if possible, and also prioritize the list just in case it isn’t.
Your doctor doesn’t benefit from hearing what you think you should say, instead of what’s really going on. Maybe you stopped taking your medication because it made you nauseated, felt ineffective, killed your libido, caused mood changes, was dosed too many times per day, or is too expensive. Getting the right medication for you—not just for your condition—is incredibly important, so if you need an alternative, speak up.
One of the first experiences you have when you get to your exam room is having an assistant ask you about your medications, as they enter them into an electronic record. Oftentimes the list that ends up in your record isn’t completely accurate because the office staff couldn’t find the right match in the system, you may have forgotten the dose or exact name of med, or you left out some medications that you didn’t think were relevant to the particular visit – maybe because it was prescribed by another provider, it’s something you only use now and then, it’s a topical med, etc.
It’s important to know that the system your doctor or nurse is inputting your medical history into doesn’t usually have information about your medications other than what you tell them.
Be prepared for your doctor appointments with information regarding all of the prescription medications you’re taking including topicals, inhalers, eye drops, etc, from all of your health care providers. Also inform them of medications you may only take occasionally. Even if you don’t use a medication every day, it is still an important part of your story. Over-the-counter drugs, dietary supplements, and herbal supplements are important too, as these can cause potential drug interactions just like prescription drugs.
The medications you’re taking can play a major role in how you are feeling, in determining the best and safest treatment choices for you, and potentially as a cause of your symptoms.
One of the first experiences you have when you get to your exam room is having an assistant ask you about your medications, as they enter them into an electronic record. Oftentimes the list that ends up in your record isn’t completely accurate because the office staff couldn’t find the right match in the system, you may have forgotten the dose or exact name of med, or you left out some medications that you didn’t think were relevant to the particular visit – maybe because it was prescribed by another provider, it’s something you only use now and then, it’s a topical med, etc.
It’s important to know that the system your doctor or nurse is inputting your medical history into doesn’t usually have information about your medications other than what you tell them.
Be prepared for your doctor’s appointments with information regarding all of the prescription medications you’re taking including topicals, inhalers, eye drops, etc, from all of your health care providers. Also inform them of medications you may only take occasionally. Even if you don’t use a medication every day, it is still an important part of your story. Over-the-counter drugs, dietary supplements, and herbal supplements are important too, as these can cause potential drug interactions just like prescription drugs. The medications you’re taking can play a major role in how you are feeling, in determining the best and safest treatment choices for you, and potentially as a cause of your symptoms.
Often, once the doctor is in the room, the visit will focus on the symptoms you’re experiencing, treatment options, and necessary tests to take. What medications you’re using and what role they may play in the symptoms you’re experiencing may get only a sliver of time, if any at all. But your experience in taking medication—especially if you’re having challenges taking your medications as directed, concerned about side effects, or even just wondering if the medications are working, whether your dose needs to change, or even if it’s time to stop your medications—is a crucial part of the conversation. So, make sure to ask about your medications—and that includes over-the-counter drugs, herbals, and dietary supplements.
Sometimes, patients get so focused on what’s going on during the office visit, they neglect to get more direction in terms of what happens next. For example, do you need to come back for a follow-up? If so, when, what’s dictating the time? How will you know if your treatment is working? Do you need to take lab tests to know about the effect or potential side effects of a medication? What should you do if there are side effects to your treatment that are troubling? Talk next steps before the visit ends.
In general, the most important strategy is to be open to communication about your needs, fears, and reactions. Using that 17 minutes to collaborate with your doctor on a treatment plan that works for you is definitely time well spent.