drugs
Adherence to Drug Treatment
Improving adherence
People are more likely to adhere to treatment if they have a good relationship with their doctor and pharmacist. Such relationships involve two-way communication. Communicationcan start with an information exchange. By asking questions, doctors can help people come to terms with the severity of their disorder, intelligently weigh the advantages and disadvantages of a treatment plan, and ensure that they understand their situation correctly. By discussing their concerns, people can learn that denial of their disorder and misconceptions about their treatment can lead to forgetting to take drugs as directed, resulting in unwanted effects. Doctors and pharmacists can encourage adherence by providing clear explanations about how to take the drugs, why the drugs are necessary, and what to expect during treatment. When people know what to expect from a drug, good and bad, they and the health care practitioners involved in their care can better judge how well the drug is working and whether potentially serious problems are developing. Written instructions help people avoid mistakes caused by poor recall of their discussions with the doctor and pharmacist. Good communication is important, particularly when people have more than one health care practitioner, because it ensures that all practitioners know all the drugs prescribed by the others, and an integrated treatment plan can be developed. Such a plan can help reduce the number of side effects and Drug Interactions and possibly result in a simpler drug regimen. Participating in decisions about their treatment planmakes people more likely to adhere to it. By participating, people take responsibility for the plan and are therefore more likely to follow it. Taking responsibility includes helping monitor the good and bad effects of treatment and discussing concerns with at least one of their health care practitioners—doctor, physician’s assistant, pharmacist, or nurse. Even if the doctor, pharmacist, or other health care practitioner does not ask, people should report unwanted or unexpected effects rather than adjust a drug dose or discontinue a drug on their own. When a person has good reasons for not following a plan and explains them, the doctor or other health care practitioner can usually make an appropriate adjustment. It is wise for people to keep an up-to-date list of all of their drugs and to take it with them to any health care appointments. Believing that their health care practitioner caresalso makes people more likely to adhere to the treatment plan. People who receive explanations from a concerned practitioner are more likely to be satisfied with the care they receive and to like the practitioner more. The more people like the practitioner, the more likely they are to adhere. can also help, because pharmacists keep computerized records of the drugs a person is taking and can monitor them for possible duplication and for drug-drug interactions. People taking prescription drugs should inform their pharmacist about what over-the-counter drugs and Overview of Dietary Supplements (such as medicinal herbs) they are taking. Also, people can ask the pharmacist about what to expect from a drug, how to take it correctly, and which drugs interact with each other. Support groupsfor people with particular disorders are often available. These groups can often reinforce the importance of following a treatment plan and provide suggestions for coping with problems. Names and telephone numbers of support groups can be obtained through local hospitals and community councils. Memory aidscan help people remember to take their drugs. For example, reminder cards can be placed in different areas of the home, or taking a drug can be associated with a specific daily task, such as brushing teeth. A wristwatch that beeps can be used as a reminder of when to take a drug. A health care practitioner or the person can mark the drug dose and the time of day to take it and the person can mark it on a calendar. When the drug is taken, the person checks the appropriate space. can be provided by a pharmacist. Daily doses for a month may be packaged in a blister pack marked with calendar days, so that people can keep track of doses taken by noting the empty spaces. Caps or stickers the same color as the tablet or capsule can be placed on each container to help people match the drug to the instructions on the container. Multicompartment medication organizers that contain compartments for each day of the week and/or for different times of each day can be used (see Drug Errors ). The person or caregiver fills the compartments on a regular basis, such as at the beginning of each week. By looking at the organizer, the person can determine whether the pills have been taken. Containers with a computerized capare available. These caps beep or flash at dosing time and can record how many times a container is opened each day and how many hours have passed since the last time the container was opened. Another alternative is a paging service with a beeper (available from subscriber-based telecommunications companies). 