Phil Moeller: Don’t forget to take your meds

My pill box has grown into a 4-by-10-inch multicolored container with 14 compartments for daytime and nighttime meds. People with more frequent medication needs probably have even larger containers. Some pill boxes have electronic alert features, including remote notifications to family members and caregivers.

Once a week, I fill my box with an entire week’s supply of meds. It has a prominent storage place in my kitchen. At mealtimes, I have a pill dish where I transfer that meal’s pills from my pill box. 

Or at least that’s the idea. Most weeks, however, when I go to refill my pill box, I find one or even two still-full compartments. I’ve simply forgotten to take my meds. This most often happens when I don’t eat at home but it also can happen when I’m at home and distracted.

Still, I’m likely a member of the “gold star” club when it comes to “medication adherence” – which means taking your medications as directed by your doctor or pharmacist, so that they work as safely and effectively as possible.  

Medication adherence plays a key role in everything from maintaining good control of chronic conditions to recovering from an illness or health care procedure. Not adhering to your doctor’s directions may lead to serious health consequences and also cost the U.S. health care system as much as $300 billion a year.¹

Research shows the risk of missed doses or interactions with other drugs can increase with multiple medications, which can be a real concern for people as they age, since about 68% of older adults take three or more prescription drugs.²

Yet decades of efforts to deal with nonadherence show them to regularly fall short. A 2022 government report reviewed an impressive inventory of steps that doctors, nurses and caregivers take to improve patient compliance:³

• Face-to-face education sessions with patients
• Automated email and text reminders
• Partnerships with churches and faith-based organizations
• Income support to improve affordability
• Altering dosages and changing the form of a medication to improve adherence

 “Unfortunately, medication nonadherence has been prevalent,” the report said, “culminating in worsened health conditions, increased cost of care, and increased health care spending.”

But changing behaviors is tough. There are reasons we like junk food and find it hard to exercise. There are lots of impediments to taking the drugs that our doctors have prescribed to improve our health.

Efforts to change medication delivery systems have been impressive. Yet, getting the right meds in the correct dosages and in the right forms – pills, gelcaps, gummies, liquids, etc. – can be challenging. Some people facing these barriers wonder if the effectiveness of their meds is worth the hassle.

Something as simple as prescriptions lasting 90 days vs. 30 days out could affect adherence, according to a University of Pennsylvania announcement explaining recent research.⁴ “Researchers ‘nudged’ doctors toward this through a default change in the electronic health record that made prescribing a 90-day supply of the medication the default option instead of actively choosing a 30-day supply,” it said.

Based on this, doctors were more likely to prescribe 90-day supplies – which meant fewer pharmacy trips and potentially greater adherence with more likelihood for the patient to have the drug on hand.

Recruiting a spouse, family members and caregivers to nudge you also may be effective. My wife and I take our meds together at mealtimes. If one forgets, the other is there to remind them. Formalizing our behavior turns it into a ritual. Rituals may increase compliance.

Think about ways you can look to create or strengthen rituals in your life, too.

Oh, and take your meds.