I came across an interesting, but not unsurprising press release this morning. It seems that a study done in Spain found that over 15% of patients who received a new prescription did not get it filled. The study, which was published in the British Journal of Clinical Pharmacology, found that initial medication non-adherence, or non-compliance, was 17.6%.
The most common medication prescriptions not filled were for a certain type of pain reliever (22.6%) and the least common was for ACE inhibitors, usually used to manage high blood pressure, hypertension (7.4%).
Understanding why someone doesn't fill or take a new prescription is important and it can have a substantial impact on a person's health. Do they not fill the prescription because they don't agree with the diagnosis? Can they not afford the medication? Do they plan to do so later but then get too busy or forget? Did someone talk them out of it?
The researchers did find that the patients who were most likely not to fill their prescriptions were:
- Younger adults,
- Americans (the study was done in Spain),
- Having a psychological or psychiatric disorder,
- Having a pain disorder, or
- Receiving treatment by a substitute/resident GP in a teaching center.
"We are especially concerned about the high rates of initial medication non-adherence in chronic treatments such as insulins, statins, or antidepressants and suspect that it is also related to an increase in costs, so we are designing an intervention targeting high risk patients," said Dr. Maria Rubio-Valera, senior author of the British Journal of Clinical Pharmacology study.
So what can we do to about this? Patients must take control of the conversation, no matter how hard
it might be. Patients need to ask their doctors why they are prescribing medications. If they don't understand the responses, the patients need to push for clarity. And if the patients feel they won't or don't want to take their medications, they have to relay this to their doctors so alternative treatments can be discussed. It's not a good idea to let the doctor believe you are going to be compliant if you don't plan on it.
And how can healthcare professionals help? Nurses, for example, are often in a good position to question why patients aren't taking their medications and to explain why the medications are necessary. Many times patients will tell nurses things that they would never discuss with their doctor. And doctors need to be aware, or more aware, of why their patients may be reluctant to fill that prescription. Taking a few minutes to explain why it's important and to actually ask if there are any concerns regarding the medication, the treatment overall, or even the cost, could make a big difference.