Compliance is hard, whether it be a diet, an exercise regime or taking your medication as prescribed – it’s not always easy to stay on track.
I always remember something I was taught during university from one of my lecturers. One third of people with high blood pressure are not diagnosed and of those that are one third don’t take their medication as prescribed. While the diagnosis of high blood pressure may have improved due to enhanced screening in the last 15 years there is definitely still an issue with compliance to medication therapy.
The reasons for poor compliance to medication regimens are diverse and complex but 3 of the most common reasons are:
1. Cost as a Barrier
With the patchwork of public and private insurance that exists across Canada we still have patients falling through the gaps that simply don’t feel like they can afford to take their medication.
2. Perceived benefit of a medication
Conditions like blood pressure often present as asymptomatic – meaning there are no obvious symptoms of the condition, so it is easy for people to skip medication unless they understand the need for taking it, because they feel the same regardless of whether they take their medication as prescribe or not.
3. Side Effects of a particular medication
Side effects, if not managed correctly can lead to poor compliance.
These are 3 common reasons for patients not taking their medication as prescribed. When we add in any form of cognitive impairment or decline we can see that adherence to any particular medication regimen can be very challenging.
Issues with compliance can be 2-fold for people living with cognitive decline – I have seen examples where patients forget to take their medication completely or equally as problematic they take their medication early in the day, forget that they have taken it and then end up taking again on the same day.
Luckily if you are caring for a loved one with dementia or any form of cognitive impairment there are strategies we can utilize with the aim of improving adherence and improving outcomes.
1. Smart Technology
If cognitive impairment is mild and just the odd pill is missed and the patient has a smart phone or device then there are many apps available for free download to help patients remember to take their medications. Two of the top-rated apps that are worth checking out:
A. My Med schedule Plus
B. My Meds Plan
The Pharmasave App also has a convenient pill reminder function that our patients can utilize.
2. Med Align
Sometimes people on multiple medications run into confusion because they are always due for refills at different times of the month. It can sometimes be of benefit to have a patient’s refills all line up so they are only coming to the pharmacy once per month to collect their regular medication. This streamlining of refills may help with compliance and this is a service that we are happy to offer our patients.
3. Compliance Packaging
Some patients use a pill reminder case, where they place all their medications for the week in a case that clearly marks the days of the week and this can help remind them to take their medications on time every day.
If there are any concerns that patients or caregivers have about doing this, pharmacies also offer this service for patients if it will help.
If you have any questions around managing medications for your loved one with dementia then please do not hesitate to contact me – there are things we can do to try and improve adherence and ultimately clinical outcomes.