Taking Prescriptions As Prescribed

For most, getting sick is a rare inconvenience. For college students, however, contracting illnesses is particularly common, especially while living in large communal buildings like dormitories. I know from experience that infection is a nuisance, especially for a busy college student. Taking prescription medicine is not only prohibitive of common activities such as drinking alcohol, but it is also hard to remember to take medication on schedule.

Taking medicine as prescribed is called compliance, concordance, or adherence. While one may immediately think of the elderly and products marketed to the elderly for pill-taking, people of all ages have trouble adhering to prescription instructions. Nonadherence has negative impacts on patient health outcomes and healthcare costs. Patients, drug companies, and the public health sector are all affected by the levels of medication adherence.

High costs and lack of access to pharmacies, as well as poor efficacy of drugs, contribute to nonadherence. “As a college student, it’s hard to remember to take medication like antibiotics when your daily routine is never the same,” said Gaby Riseser, a second year at UC Berkeley.

A 2005 study found, for specific diseases, more than 40% of patients may experience adverse outcomes due to misunderstanding, forgetting, or ignoring healthcare advice. Patients may be unaware of the risks associated with not taking medications on schedule. “It’s easy to fall into the habit of stopping [to take] medicine when you start to feel better,” Rieser added.

Efforts in improving medication adherence for patients have been heavily funded by pharmaceutical companies.

Pharmaceutical companies are spending large sums of money on campaigns to improve awareness, though their stake in this issue can be attributed to a profit incentive: The drug industry loses tens of billions in sales when patients don’t fill, or refill, their prescriptions. Still, patients can benefit health-wise from these campaigns.

From a public health standpoint, medication noncompliance negatively affects the larger population. Not only do nonadherence costs account for $100 billion to $300 billion, or 3% to 10% of total healthcare costs in the United States, but these are avoidable costs that can be decreased through patient education and collaborative communication between patients and doctors. Another public health concern is antibiotic resistance. Studies have shown that when a course of antibiotics is stopped prematurely and is disposed of incorrectly — for example, by flushing medications down the toilet — the antibiotics enter the environment and can contribute to the evolution of antibiotic-resistant bacteria.

In “Adherence to Long-Term Therapies: Evidence for Action,” the World Health Organization summarizes the importance of patient adherence by quoting the findings of journal article: “Increasing the effectiveness of adherence interventions may have a far greater impact on the health of the population than any improvement in specific medical treatments.” Taking prescriptions as prescribed is a win-win situation for all of its stakeholders.