The Right Medicine

A new report has the medical community wondering why Americans and people in other developed nations around the world aren't taking their medicine. Missed doses, incomplete regimens and unfilled prescriptions cost the American health care system billions of dollars each year and, what's worse, allow serious diseases to progress without the proper course of treatment.

According to the study, commissioned by the National Community Pharmacists Association (a group with dozens of members in our Southern Missouri towns and cities), a wide variety of reasons is cited for a patient not taking their prescribed medication. Nearly half of the patients responding to the survey said they forgot to take a prescribed medication, 31 percent did not fill a prescription, a quarter took less than the recommended dosage, and eight percent said they didn't understand the instructions on how to take a medication. With varying degrees of seriousness, all of these statistics represent causes for concern.

The consequences can be severe, as skipping pills, cutting them in half, not finishing or not refilling prescriptions can lead to poorer health outcomes. Medical treatments take longer to complete. Diseases linger rather than fall into remission. Conditions worsen and the risk of complications can rise. And stress accumulates as patients worry about their continuing symptoms, their inability to afford their medications, or whether they have the right information about dosages. All of these difficulties for patients end up costing them in the long run, along with health care providers, taxpayers, and everyone else who depends on access to our health care system.

Fortunately, we have a partner in the effort to ensure U.S. patients receive medicines in their proper doses. The pharmacists working every day in our rural communities engage in a partnership with their patients. They are a reliable source of information about the medicines they dispense. They can tell patients whether a generic is available to them, how to get the most out of their Medicare Part D or private prescription drug coverage, and most of all the importance of taking the complete course of medicine prescribed by a doctor.

In addition, systems are being developed which can indicate to a doctor or a pharmacist whether a patient is refilling prescriptions as they should. It's a new way to use technology to have a secure, private conversation between patients and their providers. With the right information, the pharmacist or the doctor can talk to patients about whether the cost of medication is affecting their ability to refill prescriptions, if the course of treatment is causing unpleasant side effects that can be overcome with a change in dosage, or if it's as simple a matter as the patient forgetting to refill the prescription.

When systems like this have been put into practice on a trial basis, the results are astounding. One pharmacy care program at Walter Reed Army Medical Center measured the affect of the program on a group of patients age 65 and older who were taking at least four medications. They found the percentage of patients who adhered to their regimens went from 61 percent to 97 percent in six months. For those who discontinued the pharmacy care program, the rate dropped back down.

To me, these kinds of examples serve as a reminder that it is extremely important to recognize pharmacists as major partners in our medical care. Many of us see the doctor a couple of times a year, but we see our pharmacist once a month -- when we have a question about over-the-counter cold medicines for our kids, when we need to know if the medicines we are taking are compatible or side effects are unusual, and when we fill and refill our prescriptions. Taking the time to get our prescriptions correct is a responsibility we all bear to be healthier in the long run, and our pharmacists should have every tool they need to help us out.