A spoonful of motivation helps the medicine go down

We have all done it. We are prescribed a medication to help us, but we don't take it as directed, or at all. Sometimes we don't even fill the prescription.

Why? Things get in the way of getting to the pharmacy. One last phone call at work or one more math problem with your child. Or we begin to feel better and stop taking the medicine. Or we don't understand the instructions. Or we are not convinced the medication will work. Or there are side effects we do not like. Or the medication is too expensive.

Or any of a hundred other reasons.

Adherence is how well we follow the recommendations from our health provider. Medication adherence ranges, but the track record isn't good, with the average rate about 50%.

What are the consequences of non-adherence? Disease progresses. Medications are wasted and become less effective in the long term. Hospitalization risk increases. As a society, the potential financial cost of non-adherence is $100 billion per year. As the late former Surgeon General C. Everett Koop said, "Drugs don't work in patients who don't take them."

Partner with your provider to maximize motivation

While there are many factors that influence adherence, motivation plays an important role. Increasing motivation to stick with a medication regimen requires work by both the patient and the provider.

Think about your current and future life goals and how this medication can help you reach these goals. Clearly communicate these goals to your provider and encourage your provider to help connect taking your medication correctly to your life goals and values. Explain your schedule and activities, and ask him or her to help find a medication regimen that fits your lifestyle as closely as possible, to make adherence as easy as possible.

Ask direct questions about the medication, including how often to take it (fewer doses are better!), potential side effects, and cost. Repeat the answers back to ensure you're clear on the instructions. At your next visit, talk about how you are doing with taking your medications. Don't be afraid to bring up any barriers that prevent you from taking them regularly and correctly, including cost.

Other tips for sticking with your medications

There are several ways to increase motivation to take medication as prescribed.

• Think about why you are taking the medication in the first place. Will it help reduce pain so you can return to work? Prolong your life so you can spend time with your grandchildren? Find ways to remind yourself of why it is important and visualize the results of success! Put a picture of your family next to your medicine.
• Track progress in a journal. Use a sticker chart and reward yourself (a movie, a special purchase) regularly and often.
• Take your medication at a similar time each day. Perhaps you can combine taking the medication with other regular, daily activities that are already part of your routine (for example, brushing your teeth), so taking the medication becomes "automatic."
• Use a medication planner/pill box. Send yourself email and text reminders.
• Enlist family and friends to help with these strategies.

So, develop a plan to increase your motivation to take your medications as prescribed, and find strategies to be successful. Your life goals will thank you!

Sources

Medication adherence: WHO cares?Mayo Clinic Proceedings, April 2011.

Adherence to medication. New England Journal of Medicine, August 2005.

Adherence to Long-Term Therapies: Evidence for Action. Geneva, Switzerland, World Health Organization, 2003.