Why Patients Stop Taking Medications

Lisa D. Ellis

Reviewed by QualityHealth's Medical Advisory Board

Have you ever stopped taking an antibiotic a few days earlier than directed because your symptoms had resolved and you figured you no longer needed it? Not following directions when it comes to taking medications can result in their failure to completely cure your illness, and it may get worse or reoccur. Furthermore, the medication may not work as well if you become sick again. Luckily, today there are many options to help you stay on track and avoid this risk.

The Problem of Medication Misuse

"Approximately 50 percent of Americans are non-adherent with their medication," says Shane P. Desselle, a registered pharmacist, PhD, Professor at Touro University California College of Pharmacy, and President of Applied Pharmacy Solutions in Vallejo, Calif.

What does non-adherent mean? It refers to stopping medications early, not filling prescriptions, not taking medications as directed, skipping doses, taking too much medication to make up for missed doses, combining the prescription improperly with other medications, or taking it with food that can interfere with its effects. Any (or all) of these scenarios can put you at risk for some serious medical consequences.

The cost of this non-adherence can be steep: "About $290 billion is spent annually on medication non-adherence; $100 billion of this is spent on hospitalization," says Hayden B. Bosworth, PhD, Professor of Medicine, Psychiatry, and Nursing at Duke University Medical Center.

Who Is Most at Risk?

The people who are most vulnerable to not taking medications properly are those without insurance coverage "or those who are underinsured and have been prescribed therapy too expensive for them, those with low health literacy, those with complicated medication regimens (often seniors), and those without adequate social support to assist them and encourage them to take their medications," Desselle explains.

Dealing with more than one medical issue can affect adherence, too: "Conditions like depression or anxiety (and others) can further exacerbate [intensify] non-adherence due to the patient's mental state, thus making that patient feel ill-prepared or just not wanting to take the medication because he or she is depressed or anxious about having to do so," he points out.

But while some groups are more susceptible, anyone can be at risk for medication misuse, regardless of age, income level, and health status. In fact, "Well-educated patients may think they know better. They may have found conflicting data about the medications on the internet, and decide unilaterally [on their own] what they wish to do," says Samuel Sandowski, MD, Director of the Family Medicine Residency Program and Director of Medical Education for South Nassau Communities Hospital in Oceanside, NY.

What You Can Do

With medication misuse such a widespread problem, Bosworth says that there’s no one-size-fits-all approach to address the issue. But there are things you can do to make sure you and your family members take all of your medications properly and get the full therapeutic benefit:

Talk to your doctor about your prescriptions. Ask why you are taking any medications, what the benefits are, and what harm could result if you skip doses or stop taking your medication(s) early.
Reach out to the pharmacist when you fill a new prescription. Make sure you understand how to take the medication, when to take it, and whether you need to take it with or without certain food or drinks. Ask what to do if you miss a dose, and what some of the possible side effects are and how to manage them.
Tell your pharmacist if you can’t afford your medication or find the side effects troublesome. "The pharmacist can advocate for you and suggest treatment alternatives to the prescriber and can also seek remedy from your insurance company," Desselle says.
Shop around for the lowest price for your medication. The cost can vary from pharmacy to pharmacy for some drugs. You can also ask your pharmacist if there is a lower-cost generic option you can take instead of a more expensive brand-name drug.
Contact the pharmaceutical companies directly if you need help paying for your medication. You may qualify for help. "There are many existing programs to help various patients. Some pharmaceutical manufacturers offer medication assistance programs if patients contact them directly to determine eligibility, or a patient can speak with a pharmacist, health plan administrator, or social worker from any advocacy agency such as their local Area on Aging, for seniors," Desselle says.
If you’re a senior citizen on Medicare, find out what resources are available to you through this federal plan. "Seniors might qualify for extra help under their Medicare Part D plan [a federal program to subsidize medications for Medicare beneficiaries] if they are enrolled in one, and medicare.gov is an excellent resource," Deselle says.
Ask your doctor, pharmacist, or family member to help you create a medication chart. This will help you manage multiple prescriptions.
Explore online and mobile apps that offer medication management tools, reminders, and schedules that can make staying on track easier. Many of these are free of charge.
Use tools like a divided pill box. This can help you remember which pills to take and when.

The Need to Speak Up

The most important thing to remember when you’re struggling with following your medication directions is that you aren’t in this alone. "If one does not plan on taking a medication, using a treatment, or following the recommendation of the physician, that is perfectly acceptable," Sandowski says. "However, it is critical that the patient disclose this to the physician, so the physician can offer alternatives that may be effective, and so the physician is not making presumptions about the care the patient is receiving."

When you keep the lines of communication open with your healthcare provider, together you can figure out the best way to take your medications properly to get the full benefits.

Shane P. Desselle, RPh, PhD, FAPhA, reviewed this article.