What Is Adherence and Why Does It Matter?
By: Nurse Catherine
One question that comes up with my relapsing multiple sclerosis (RMS) patients all the time is, “Is it really so important that I take my medication exactly as my doctor says?”
The answer is a resounding yes! Taking medication in the way it is prescribed is known as adherence—a critical part of managing MS, or any condition. Whether your treatment is daily, weekly, or has several months in between doses, it is critical that you follow your dosing regimen exactly as prescribed.
You may wonder, “What could be the harm if I skip a dose or treatment appointment every now and then?” Think of it like this: all of the research and studies that go into the development of a medication determine the most effective way for it to work. While different treatments have different dosages and schedules, they often require that a certain level of medicine be inside the body for a period of time to achieve a desired result.1
Additionally, starting and stopping medications without your doctor’s permission may not only reduce the effectiveness of the treatment, it may even cause harm. Studies have shown that nonadherence to medications for a variety of chronic conditions accounts for 10% to 25% of hospital and nursing home admissions in the United States.2
And for certain medications, it’s just as important to adhere to the testing and monitoring that is needed. That means making sure to keep all of your appointments and regularly performing any self-checks as required.
Improving Adherence: What can you do?
Whenever a patient shows that they are having trouble with adherence to their medication, I want to know what the obstacles are, and work with that patient to help customize a strategy for success.
Here are some of the more common adherence topics I discuss with patients, and some possible solutions.
Adherence topic: Confusion/misunderstanding of treatment schedule
This usually happens during the initial conversation with the healthcare provider. When you are talking with your doctor, make sure to write down the proper dosing and schedule exactly as he or she tells you. Display it somewhere obvious, such as on the bathroom mirror or refrigerator door. Include how much medicine to take (number of pills or mg of medicine), how to take (orally, subcutaneous injection, etc) and how often to take it (several times a day, once a week, etc). Leave it up until it becomes second nature to you. Make sure family members or care partners know the proper schedule also so they can assist you.
Adherence topic: Remembering to take medication
We all have busy lives, and sometimes important things just fall through the cracks. It helps to use adherence aids, such as monthly pill boxes, reminder alarms, and mobile apps. Ask a care partner to give you a gentle nudge by phone or text. Mark a big red X on your calendar after every dose or align it with something you do every day, like brushing your teeth or watching your favorite TV show.
Adherence topic: Experiencing side effects
Many medications have common side effects, which may range from mild discomfort to more serious conditions. The most important thing is that you speak to your healthcare provider right away and discuss possible solutions for managing side effects. Never skip or stop your medication without letting your doctor know, and always share any side effects you may be experiencing.
Adherence topic: Doesn’t fit my schedule/lifestyle
Occasionally, after starting a medication, it becomes apparent that something about it just isn’t right for you. The good news is that there are often different treatment options that may fit your schedule or lifestyle better. All it may take to find the right treatment for you is having an open and honest conversation with your healthcare provider. Together you can discuss what the problem is, and what your other treatment options are.
You should take a closer look at your treatment’s dosing schedule, usually found in the Medication Guide that accompanies your prescription, or on the medication’s website. And always check with your healthcare provider if you aren’t sure about how to take your medication.
Remember, along with communication, support, and some careful planning, adherence to your medication is the key to getting results.
References: 1. Kramer TAM. Side effects and therapeutic effects. Medscape. https://www.medscape.com/viewarticle/448250. Accessed May 24, 2018. 2. Smith DL. Compliance packaging: a patient education tool. Am Pharm. 1989;NS29(2):42-45, 49-53.