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Medication Compliance in Older People is Still a Huge Challenge

January 12, 2012

Perhaps you have missed taking a pill or multivitamin for one reason or another. However, older people are particularly notorious for not sticking to their medication schedules. After all, they take more drugs than any other age group. As much as 75 percent of the elderly population in the United States are non-compliant according to Harvard Medical School.

While the reason for these numbers may seem obvious, there is usually more than one explanation. Many people assume the effects of aging simply make it harder for seniors to follow a drug regimen. However, it is overly simplistic to blame aging as the only reason for non-compliance. Other factors may contribute to the problem.

  • Chronic diseases make it tougher to take medications. Someone may get dizzy because of high blood pressure, or his vision has deteriorated because of glaucoma. These are some examples where diseases can make it harder to see drug labels properly or omit taking it altogether.
  • False beliefs regarding their illnesses can trigger mistakes. Some people overuse their medications in the belief that it will hasten their recovery. While others avoid or lessen their intake because they feel worse from the side effects and they see that as compounding, rather than alleviating, their existing condition.
  • The elderly become more isolated as time goes by. Many old people live alone. Their families are not always there to remind them to take their pills. They have to rely on themselves to follow a schedule. The situation makes it more likely that they will skip taking medications or take them by mistake. Multiple drugs just make it more confusing for seniors. As they are beset by illnesses such as dementia and other mental health problems, many of them are bewildered by the dosage, timing and frequency of taking their medicine. Some simply forget and others just give up trying to figure it all out.
  • The high cost of drugs dissuades seniors from using them. Many of them are uninsured or partially insured and they cut back on medication because of increasing cost.

Medication non-compliance among the elderly population is an important issue. Many are hospitalized or re-admitted shortly after discharge because they could not follow home instructions. Chronic conditions are worsened by mistakes in taking prescription drugs or experimenting with supplements and over-the-counter products.

Frequent admissions due to non-compliance also place added burden on the health care system. If we could promote better compliance among seniors, then health care costs would go down. There are several ways to ensure compliance among the elderly. Some of them include:

  • Better communication between clinicians and elderly patients must be established. Health care providers must probe further regarding the beliefs and behaviors of seniors towards taking medications. Older people are reluctant to ask questions about their pills. They need to be encouraged into opening up and be given clear instructions about the medicine they are taking.
  • Caregivers and family members must shoulder some of the responsibility for compliance. They are able to obtain and administer drugs at home more safely based on the daily drug schedule. Because caregivers spend about 20 hours per week providing care, they can be a valuable ally for physicians in this regard. For a senior living alone, friends and family can call, e-mail or visit regularly to check if there are any problems.
  • Health literacy among the elderly should be improved. Some older people cling to outdated beliefs and attitudes toward disease and modern medicine. Some fear the social stigma that comes from taking multiple drugs, while others don't want to be bothered by the names, appearance, and interactions of drugs. By providing education and important facts without overwhelming information, we can help older people take their pills correctly.

On a more practical note, here are 7 things you can do to improve medication compliance among the seniors.

  1. Use a compartmentalized pill box with labels for every day of the week and/or different times of the day.
  2. Write simple but clear notes about every medication. Ask the pharmacist to print larger labels.
  3. Seek the help of others in ordering, sorting and preparing your medications.
  4. Ask questions during every visit to your physician. If possible, ask to be accompanied by a loved one or caregiver during a visit.
  5. Put color-coded labels on your medicine bottles.
  6. Set up alarms and reminders using mobile phones for the right timing of taking your pills.
  7. Make it a habit and associate medications to other activities. For example, take the blue pill after breakfast, and the white one at dinner time.

Medication non-compliance remains a big challenge for older people. Not taking medications properly can be very dangerous for them. We must help in making sure they only take the right medications. Sticking to the right drug regimen is one key to staying healthy during the golden years.

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