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. 2012 Jan-Feb;127(1):2–3. doi: 10.1177/003335491212700102

Medication Adherence: Helping Patients Take Their Medicines As Directed

Regina M Benjamin 1
PMCID: PMC3234383  PMID: 22298918

Seventy-five percent of Americans have trouble taking their medicine as directed.1 This lack of adherence is costing many people their good health and the health-care system billions of dollars. Estimates are that approximately 125,000 deaths per year in the United States are due to medication nonadherence2 and that 33% to 69% of medication-related hospital admissions are due to poor adherence.3 The total cost estimates for medication nonadherence range from $100 billion to $300 billion every year, when both direct and indirect costs are included.4–8 Also, nearly half of all Americans—133 million people—suffer from at least one ongoing or chronic health condition. That number is expected to grow to 157 million by 2020.9

Our national challenge is to become a healthy and fit nation and to prevent poor health outcomes. One way we can prevent serious health complications and even death is to ensure that people take their medicines as directed—especially those people who have multiple chronic conditions and must manage a number of different medications to help them stay as healthy as possible. We need to involve the health-care community and patients, working together to address the serious public health issue of medication adherence.

Many barriers can lead to poor medication adherence, such as the prohibitive high costs and copayments that some people must pay for their prescription medicines.10,11 Patients frequently have difficulty remembering or managing multiple medications or complex regimens, often prescribed by multiple doctors,12–14 or they do not understand the reasons for and importance of drug therapy.15,16 Poor health literacy is another barrier and an important contributor to nonadherence.17–20

Physicians, nurses, pharmacists, and other clinicians play a critical role in addressing this public health issue. As a family physician in rural Alabama, I often treated patients whose primary reason for taking their medications incorrectly was not understanding the instructions. Proper medication adherence starts with conversations. Make sure your patients know how to take their medication. Have them repeat the directions to you before they leave. Also, let them know why they are taking the meds and what to expect.

The Institute of Medicine reported that “Pharmaceuticals are the most common medical intervention, and their potential for both help and harm is enormous. Ensuring that the American people get the most benefit from advances in pharmacology is a critical component of improving the national health care system.”21 This past spring, I joined with colleagues from the Department of Health and Human Services and the National Consumers League, a coalition of more than 100 of the country's most respected public and private organizations, to launch a national campaign called Script Your Future.22 This campaign, together with the Food and Drug Administration's medication safety programs,23,24 raises awareness of the importance of taking medications as directed. The campaign is highlighting resources, and the evidence base to support the importance of improving medication adherence, that are readily available to health-care professional groups, advocacy and support groups for chronic illnesses, health insurance plans, pharmaceutical companies, business organizations, consumer groups, researchers, and government agencies. The campaign is also making available tools to help patients begin conversations with their health professionals.

I urge doctors, nurses, nurse practitioners, physician assistants, pharmacists, diabetes educators, community health workers, and others to start a conversation with your patients about the importance of taking medications as directed and to help them overcome the barriers to medication adherence. There is no better time than right now to help our patients with chronic conditions live long and healthy lives.

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VADM Regina M. Benjamin, Surgeon General

RESOURCES

Script Your Future (www.scriptyourfuture.org)

My Medicine Record (www.fda.gov/drugs/resourcesforyou/ucm079489.htm)

Stop–Learn–Go (www.fda.gov/Drugs/ResourcesForYou/ucm163330.htm)

REFERENCES

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Articles from Public Health Reports are provided here courtesy of SAGE Publications

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