Doctors will tell you to take all of your prescription, even if you begin to feel better before the deadline is reached.
This week, we are discussing the concept of taking your prescription medicines as they are prescribed. There is ample anecdotal and actual evidence that people often (indeed, too often) do not take their medicines as prescribed. A great example is an antibiotic prescription. Often these medicines are prescribed to be taken once or twice a day for a given number of days. The doctors and the pharmacists will tell you to take them all, even if you begin to feel better before the deadline is reached. What happens, in reality is that people tend to take them for a few days, until they begin to feel better and then they stop taking them. They will save the rest of them for some future anticipated need, either for themselves or for someone they care about.
We talk about the concept known as wishful thinking and how children develop their learning capacities. We all have elements of wishful thinking that remain in our thought processes as we age. This impacts our decision -making capacities and our reality testing abilities. We believe that this process is some of what is going on with regard to the magic of medicines. People rarely take all of a prescription, and then keep the rest in case of some future need. Many people actually forget that the meds are in the storage cabinet and may even forget what they were prescribed for, but they keep them as a magical elixir which will protect someone from some imagined future need or harm.
An example that is particularly relevant to Dr. Maupin’s practice at BioBalance Health is the issue of testosterone administration. There are several ways that the hormone testosterone can be replaced. At Dr. Maupin’s office the only way that the hormone testosterone is replaced for men or women is through the insertion of a pellet under the skin. This insertion creates an on- demand reservoir of testosterone in the body, which the body will then use as it needs it to maintain the metabolic process of the body. The patient does not need to do anything or remember anything or worry about regulating the amount that is absorbed into the system in any kind of consistent way. All of these concerns are dealt with by the insertion process and the reservoir!
An example is a recent article in Medscape, a medical journal for doctors. There was a headline reading: “Fewer Than 1 in 5 Hypogonadic men are Adherent To Prescribed Topical Testosterone Treatment”.
There are many obstacles to medical treatment that prevent improvement of a patient’s symptoms, but the most common and obvious roadblock is the lack of patient compliance.
It seems simplistic, but the fact that you are given a prescription and you fill it at your pharmacy does not mean you will get better unless you actually take your medication as the prescription reads.
This is the one reason I like to treat men and women with testosterone pellets. If they come to my office, they get their medication and I don’t have to depend on patients to remember to take their doses of medication, I know they have it!
This study revealed the severity of this problem with men taking their testosterone gel. A total of 3,184 men were studied and only 17% of these men remembered to take their T gel as prescribed! What a waste. Worse yet 81% of them stopped filling their prescriptions at 1 year.
It is always difficult to remember a new habit. Everyone has to do something to remember a new task like, link it to something you already do, like brush your teeth.
However if the results are obviously beneficial, such as they make you feel good or help you think such as (ADD medicine, thyroid medicine and antidepressants), then I believe the % of patients who comply is better. I think that if the testosterone treatment they studied really made men feel better, then men would remember it! However, there is a flaw in using the gels as a way to administer testosterone. They (the gels), make too much estrogen for men to really feel better, and that is most likely part of why so many men forget to take it.
Another factor in remembering to take chronic medication is the level of fear the thought of what might happen if you forget. The fear of pregnancy is a strong motivation for women to take their birth-control pills. The packaging is also an excellent method that promotes compliance. The pill packs have the day of the week on each dose so you know if you forgot and can catch up. Maybe we should package all medications that way. I have a friend who has a company that packages medicine for Medicaid in that manner. It’s a great idea.
The FDA should consider the following issues when approving drugs and drug packaging when they approve them for consumption. As a doctor I must know if the medications I am prescribing are actually being taken as I asked the patient to, or I will make the wrong assumption and change medications just because a patient won’t or can’t take it regularly.
What makes us follow the directions of our doctors and take our medications:
- Patients really want to get better
- Medications that let you know if you took it because of how it makes one feel
- Medication that doesn’t have side effects
- Pills that can be put in a dosing apparatus that hold all the pills or supplements that you take at the same time/day with the day written on it
- Pill packs that have a pill for every day on a card that you can pop out for every dose.
- Medication that actually works for the reason you are taking it!
Remember, the importance of taking medicines as prescribed cannot be overstated. Doctors and Pharmacists do all that they can to help make this a non- issue when it comes to your health. There are still concerns about the weakest link, which is YOU.
This Health cast was written and presented by Dr. Kathy Maupin, M.D., Bio-identical Hormone Replacement Expert and Author, with Brett Newcomb, MA., LPC., Family Counselor, Presenter and Author. www.BioBalanceHealth.com.