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Drug Compliance: Tips For Taking Drugs As Prescribed (Adherence)

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As the World Health Organization states: "Medicines will not work if you do not take them."

To get the full benefit of a drug, it is important to do each of the following:

  • Take a drug when you are supposed to.
  • Take the correct dosage.
  • Follow other instructions such as taking the drug with or without food.

Not following instructions can lead to extra doctor visits, a drug not working, extra out-of-pocket costs, and even expensive emergency medical care.

Taking a drug as directed can be difficult - particularly when you have to take a drug or a batch of drugs over an extended period of time. There are a variety of aides that can help.

If creating a schedule or figuring out how to integrate taking drugs into your day, speak with your doctor, or a social worker to help.

NOTE:If paying for a drug is difficult, or if you just want to save money when buying, see  How To Save Money When Buying Or Using Drugs

BASICS

  • Get clear instructions about when to take which medications and how (for instance, with or without food). Preferably the instructions will be in writing so you can refer to them as needed.
  • Keep track of when to start and stop taking a particular medication.
  • Keep your medications in a place or places where you will see them closest to the time when you are supposed to take them. (for example, by the bed, or near the toothbrush).
  • Plan ahead. For example:
    • So you do not run out of medications - even if it takes your pharmacy a few days to restock the item if necessary.
    • For travel and vacations. (As you will see in our article about travel, it is advisable to carry medications with you instead of checking them and to take medications for at least a few more days than your scheduled trip "just in case.")
    • In case of emergency situations. IFor example, natural disasters which can happen anywhere at any time. Also consider such schedule busters as being delayed in traffic if you live in an area prone to big snow storms. 
  • Let family members know when you are supposed to take a drug. They can help remind you.
  • Let your doctor know if you are experiencing confusion or memory lapses.
  • Find out from your doctor what to do if you miss a dose. Keep track of missed doses so you can report them to the doctor at your next appointment.
  • If you finished treatment and are having difficulty because taking drugs is a constant reminder of something you would rather forget, consider speaking with a cancer buddy or joining a support group. If the difficulty continues, consider speaking with a social worker, psychologist or psychiatrist.

COMPLIANCE HELPERS TO CONSIDER (COMPLIANCE AIDES)

Compliance aides are products that are specifically designed to help remind you when it is time to take your medications, and/or to assist with organizing your medicines in advance. Compliance aides may be purchased at most drug stores or online - or you can create your own.. 

Following is a list of some of the compliance aides which are available commercially. Next are ideas for do-it-yourself reminders. If none of the alternatives fit your needs, ask your doctor, his/her staff or your pharmacist for advice about which compliance aide or aides may be best for your particular medical and personal situation. (Advocates report that it helps with compliance if you ask that all instructions relating to medications be put in writing.)

TIP: if you decide to put medications in an aide, it is wise to keep one in the bottle in which received so you won't wonder what pill is in what aide. .

Some of the many compliance aids currently available are:

  • Boxes that store pills and have an alarm.
    • At least one version can be programmed with up to 37 alarms from 6AM to Midnight. It features slide-out pill case with compartments to store medications. Available from e-pill Medication Reminders. www.epill.com offsite link Tel.: 800.549.0095
    • The MEDGLIDER System 7 is a portable seven day pill organizer and alarm that allows for four times a day dosing. Choose a beep alarm, a voice that says "time to take your pill" or a blinking light. Available from e-pill,LLC. www.epill.com offsite link Tel.: 800 549 0095
    • MedReady Medication Dispenser stores medication under lock and key. It holds up to seven days' worth and allows for four times a day dosing. An alarm sounds when it's time to take medication, and a single compartment advances for access. Available from Assisted Living Store. www.assistedlivingstore.com offsite linkTel.: 888.388.5862
  • Electronic pill container: A Vitality "GlowCap" is a high-tech top for a standard pill bottle. The cap reminds you when to take a pill. The device can set off an automated telephone or text message reminder to patients who fail to take their pills. It can also generate e-mail or letters reporting to a family member or doctor how often the medication is taken.
  • Individual Packets
    •  Many pharmacies create daily blister packs instead of putting pills in traditional bottles. Each packet is securely sealed and is waterproof. The packet allows you to carry your meds in single or multi-dose packets. Packets are generally date and time stamped so you can tell at a glance whether the dose has been taken. It also prevents taking a dose more than once. For example, Rite Aid and Walmart offer the service. So does Moms Pharmacy which primarily works with paients with HIV, but not exclusively. See: www.momspharmacy.com offsite link.
    • Individual packets may come with an additional charge. The charge is not generally covered by health insurance but it is worth checking "just in case."
  • Digital pill dispenser
    • MedMinder.com  offsite linkhas a pill dispenser that is locked until the time comes for medication. (Another type is unlocked.)  A caregiver can remotely program the schedule and see if the user has complied. The dispenser flashes (if locked, it unlocks) when it is pill time. The dispenser beeps if the medicine is not taken. If the beeps don't work, a pre-recorded voice that the user records acts as a reminder. If that doesn't work, the patient gets a call and a caregiver receives an e mail, text or call.
    • Reminder-Rosie.com has a voice activated talking clock that tells you to take your meds at a certain time. Once the medicine is taken, the person either says “reminder off” or touches it to turn it off.
  • Your mobile phone or device. There are various applications for mobile phones which prompt when to take medications. For example: 
    • DoseCast (free): For people who take multiple doses of medications on a daily basis. Lets you set reminders according to your own schedule. As you take doses, Dosecast tracks remaining quantities, sends refill reminders and logs compliance
    • HealthPrize (free): Provides prizes to reward good behavior
    • MedHelper (free, plus a small charge for the pro version): Works for simple or complex drug regimens.
    • MediRemind (small charge). Includes contact numbers of your medical team which makes it easy to refill a prescription.
    • MediSafeProject.com  offsite linkalerts you when it is time to take your next dose. The app works for smart phones, regular mobile phones,mobile devices and calls to a landline. If you do not take the dose, it alerts a caregiver, family member or friend.
    • PersonalMD.com has a service you pay for monthly that reminds you about meds by calling you on your cell phone or an e-mail to your pager. The service also reminds you about refilling prescriptions. personalmd.com/medreminder_description.shtml offsite link
    • PillBoxie (free): Designed for visual people
    • RxMindMe (free): Includes different reminders to choose from
    • RX Pal sends reminders about when to take your drugs; alerts you when a prescription is running low and links to your pharmacy for refills
    • Zuri (for iPhones) calls and reminds you which medication you are supposed to take at a particular time. Zuri includes a feature that allows you to note whether you took the medication or not. It also allows your doctor to see your compliance through a separate web page.
  • Watches that remind you when to take medications. For example, a watch from Cadex keeps track of up to 12 daily medications and stores a database of vital medical information. Available from Cadex, Box 22896, Ketchum, Idaho 83340 www.cadexproducts.com offsite link 

Ideas To Help Create Your Own Compliance Method

In order to maintain compliance and keep track of how to take your medications, consider creating an easy to remember system for taking your medications. While the possibilities are only limited by your imagination, here are a few methods that have worked for other people: 

  • Use a multi-box screw box available in your local hardware store can be an inexpensive compliance aid. Group your pills according to day, time and dosage. You can sort your pills every few days or once a week instead of every day, and you can easily see whether the pills for the allotted time were taken.
  • Keep your drugs in sight. If you can see your meds, you are less likely to forget them.
    • For example, if you take a pill in the morning, leave the bottle with your coffee mug or coffee maker. 
    • If the drug has to be refrigerated, keep a Post-it or similar note where you will see the note.
  • Place Post-it Notes on the inside of the bedroom or front door.
  • Put "M"s (for "Medications") on a daily calendar at times you need to take your meds. Cross off each M as you take a pill.
  • Coordinate taking your pills with a daily routine, such as brushing your teeth or watching your favorite t.v. programs.
  • Set an alarm on your cell phone, PDA, watch, or inexpensive pocket alarm.
  • Mary Sloane, 78, keeps track of five medications a day by sorting her pill bottles each evening into separate dishes. One is for morning pills, the other for the next evening. Then she turns each medicine bottle upside down after taking the pill so she can tell at a glance if she has taken it that day. "You have to have a system" Sloane says. "because just as soon as I get started taking my pills, the phone rings, and when I come back to it, I think, now have I taken that?"  (If the bottles have child proof caps, you can accomplish the same thing by placing the day's allotment of each pill on the upside down cap).
TIME TESTED TIPS IF YOU HAVE DIFFICULTY TAKING A PILL

If you have difficulty swallowing a particular medication, including if it sticks to your throat, consider the following options:
  • Sit upright or stand when taking a pill.
    • Do not throw your head back when taking pills. (It can increase the risk of choking).
    • Consider tucking in your chin by lowering it slightly toward your chest.
  • Swallow one pill at a time.
  • Take smaller pills if possible. If that doesn't work, consider trying larger pills.
  • Crush a pill and mix it with a substance such as apple sauce to ease its movement. Before crushing a pill, check with your doctor or pharmacist to find out if crushing is okay. Some pills lose their effectiveness if crushed.
  • Moisten the mouth to help the pill go down more easily. For instance, take a sip of water just before taking a pill. 
    • If you take a few sips of liquid with or after each pill you will help prevent it from getting stuck in your asophagus.
  • Some people find carbonated drinks more effective than water in helping a pill go down. 
  • Ask your doctor or pharmacist if the pill can be taken in another form that is easier to swallow. For example, a liquid, a patch, or through a needle. If they don't know about these alternatives, contact a compounder. Compounders specialize in changing the form of a pill without changing the effectiveness.
  • Try "effortful swallowing." This means consciously making each swallow more forceful than normal.
  • Review your list of medications with your doctor or pharmacist. Some drugs interfere with saliva and swallowing and may be the cause of the problem. If so, perhaps alternatives are available.
  • Change the form by means of compounding. Drugs can be transformed into a different form, such as lozenge, gummy bears or even Popsicles or lollipops. All drugs are compoundable as long as there is not a patent on the form you need. To learn more, contact a compounder.

If a drug melts in your mouth and tastes bad, consider the following tips: 

  • You can numb your taste buds by sucking on something cold such as ice chips or a popsicle.
  • Conceal the unpleasant taste by putting pills into empty medicine capsules and then swallowing. Empty medicine capsules are available at drug stores and health food stores.
  • Find out if the drug comes in the form of a "drug patch" (transdermal drug-delivery system.) The medication's active ingredient is integrated into the adhesive gel on one side of the patch. When you wear the patch, the drug passes through the skin into your bloodstream.
  • Change the form by means of compounding. Drugs can be transformed into a different form, such as lozenge, gummy bears or even Popsicles or lollipops. All drugs are compoundable as long as there is not a patent on the form you need. To learn more, contact a compounder.

NOTE:

  • To learn how to store drugs safely, click here.
  • To learn about renewing prescription drugs, click here.
  • For information about what to do it in insurance carrier insists that you switch drugs, click here
  • It is wise to keep a List of Medicines with you at all times so your doctor or other health care provider will be able to quickly check whether a drug he or she is proposing may interact negatively with a drug you're already taking. The List will also come in handy in case you need unexpected emergency treatment, whether because of your existing health condition or another reason. For a form to use, click here
  • To learn what to do with unused drugs and related supplies, click here.
  • If have difficulty swallowing food or drink, click here.
  • If you experience dry mouth, click here.
  • If you experience mouth sores, click here.

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