No Easy Way to Make Patients Take Their Medications

Medication adherence was low among many patients and researchers were unsure of how to increase it

/ Author:  / Reviewed by: Joseph V. Madia, MD Beth Bolt, RPh

(RxWiki News) Many people don't take their medications as prescribed. Researchers recently attempted to find out why.

According to the American College of Preventive Medicine (ACPM), around half of patients do not take their prescribed medicine properly.

A new study looked at common methods to get patients to take their medications. The study authors reviewed hundreds of past studies on the topic but didn't find a method that worked better than the others.

Robby Nieuwlaat, PhD, of the Department of Clinical Epidemiology and Biostatistics at McMaster University in Hamilton, Canada, and colleagues wrote the study.

Taking prescribed medication correctly is the best way to treat the heath problem it's meant to fix, these study authors said. They called for more research on the topic to find a method that would help patients follow the doctor's orders — and become healthier as a result.

Steve Leuck, PharmD, a pharmacist and founder of AudibleRx, told dailyRx News that he sees this research as encouraging — despite the fact that the results may seem inconclusive.

"What this shows me is that there is a great movement toward helping identify the most appropriate and efficient way of delivering medication and consumer medication information," he said.

Dr. Leuck said that giving patients advice is key to getting them to be compliant.

“When patients understand why they are taking their medications, and importantly, what the consequences are of not taking their medication, they are much more likely to be adherent to their pharmaceutical regimen," he said.

In a 2007 study, researchers looked at this issue and did not find any special way to get patients to take their medicine properly. Seven years later, Dr. Nieuwlaat and colleagues tried again. They concluded that no one technique made patients take their medication more faithfully.

In their review of research on the topic, Dr. Nieuwlaat and team found 182 studies that looked at varied ways to get people to take their medicine — 109 of which were recent. But they found that only 17 of those studies didn't have any major flaws in the way their authors conducted the research. Only five of the 17 high-quality trials suggested that certain techniques could encourage patients to take their medications correctly.

These studies looked at some common methods for improving medication adherence. These included giving patients pill box organizers or having pharmacists talk to patients about why the medication was important.

A few studies looked at new methods, such as mobile text reminders and Web-based support. There were too few of these studies, however, to show whether any of the new methods worked well, Dr. Nieuwlaat and colleagues noted.

"The studies varied so much in terms of their design and their results that it would have been misleading to try to come up with general conclusions," Dr. Nieuwlaat said in a press release. "Based on this evidence, it is uncertain how adherence to medication can be consistently improved. We need to see larger and higher quality trials, which better take in account individual patient’s problems with adherence."

To inspire more research on this topic, Dr. Nieuwlaat and team created a database of the studies and made it available to others in the field.

The ACPM notes on its website that there are many reasons why patients might not take their medications properly. Cost of medicine, side effects, patients lacking faith that the medicine could work and forgetfulness are just some of the reasons the ACPM cites.

The University of Rochester Medical Center (URMC) recommends on its website some ways patients can better remember to take their medications. A pill organizer is a good way to remember doses and when to take multiple pills, according to the URMC. Patients who take medications in the morning can try leaving them in strategic places to help them remember, such as on the kitchen counter by the coffee maker. The URMC says that setting a cellphone alarm clock or other device to ring when it's time to take the medication is also a good technique.

The current study was published Nov. 20 in The Cochrane Library.

The Canadian Institutes of Health Research and McMaster University funded the study. Dr. Nieuwlaat received a research grant from Boehringer Ingelheim.

Review Date: 
November 19, 2014
Last Updated:
November 22, 2014