Supermarket aisles are full of cutesy pill boxes to help people store and remember their medicines. Smartphone apps offer helpful reminders with musical tones. And yet, some of us continue to be lax about our medication schedules.
As a rule of thumb, taking medicines on time and as recommended by the doctor is essential for managing the underlying condition. It becomes even more crucial for specific situations, including epilepsy, diabetes, and cardiovascular disease. Missing one’s dosage can lead to side effects and reduced treatment efficacy.
A 2024 study published in Nature Reviews Cardiology highlights that the world is currently experiencing an increasing incidence of comorbidity and polypharmacy. These factors, coupled with population ageing, pose veritable risks for medication non-adherence.
Let’s identify the causes that hinder some of us from sticking to our medicine plans so we can address them.
General Forgetfulness and Memory-Related Problems
So, are some people just more forgetful, leading them to skip essential decisions like taking their medicines?
The WHO reports that dementia and memory problems are much more common among older adults over 65. The affected people may experience forgetfulness and confusion, often misplacing items or losing track of time.
Even among younger people, stressful events and poor work-life balance can interfere with medication schedules. You may feel too busy to focus on health and keep postponing taking medicines. A 2023 study in Molecular Psychiatry found that exposure to stress can impair memory for cognitive tasks. It can impact the brain in several ways, affecting composite, verbal, and visual abilities.
Yet another cause of memory problems affecting medication adherence is an underlying, often undiagnosed, health condition. Cleveland Clinic explains that this could be an infection, a mood disorder, or substance abuse. In some cases, general anaesthesia used for surgery can also affect short-term memory.
If these issues are interfering with your ability to stick to health goals:
- Discuss your memory troubles with your doctor to build a management plan. While degenerative brain disease has a limited possibility for cure, conditions like infections can usually be managed if detected early.
- You can seek help from a reliable caregiver or family member. They can become your human alarm system. Since it is a significant responsibility, you should discuss in depth with the person concerned before assigning them the task.
- Develop a stress management plan that prioritizes your health. This may involve adjustments to your professional life, such as fewer hours or flexible work arrangements.
- Explore tech-led assistance to remember your medicines. If too many apps feel overwhelming, try using Siri or Google Assistant. The default Health app in iOS 16 or later versions lets you add all the necessary details, including frequency and intervals.
Lack of Understanding About The Risks of Missing Medication
Another obstacle to sticking to the recommended drug schedule is limited or missing awareness about the risks of not doing so.
Popular beliefs may claim that missing your medicine for a day or two will not have a significant effect on your health. This is often the case with health supplements, such as iron or magnesium. However, this may not be the case for chronic or severe illnesses.
A CNN story notes that many people skip medication on vacation to avoid uncomfortable side effects. Doing so may be fine with drugs for weight management, with the risks focused on less appetite suppression. But the situation is different for someone with Type 2 diabetes, especially if it isn’t well-controlled.
Some drugs have a short half-life, which means the quantity of active ingredient in the body may be reduced by half within a few hours. For example, missing antidepressants like Paxil and Zoloft may start showing discontinuation effects within 12 to 24 hours. You may feel nausea, headaches, and, in some cases, depersonalization.
If you are unsure about the risks of missing (or skipping) a dosage, consider scheduling an appointment with your health professional. You can learn about your situation in detail to understand the criticality of timely dosage. You may find it more accessible to interact with your pharmacist, particularly regarding the nuances of daily routines and timelines.
Becoming a pharmacist involves detailed learning about treatment plans and safe medication use. The National Institutes of Health notes that pharmacists can improve patient medication adherence by reviewing and reconciling drugs to simplify the everyday regimen.
According to the University of Findlay, pharmacists who work in nursing homes or care facilities can provide helpful additional information to patients. These interactions are based on trust-led relationships, helping community members understand how to be in charge of their health.
Here are specific questions you should ask for clarity:
- Should I take the medicine at the same time every day? Can I change it?
- What must I do if I miss one dose? Should I take it when I remember or wait until the next day?
- Will I experience side effects if I skip my medicine for personal reasons, such as going on a trip?
- Should I skip my medicine if I am feeling unwell due to another condition?
Resistance and Apprehension About Medication
According to the National Alliance on Mental Illness, almost 30% of people with schizophrenia experience anosognosia or a lack of awareness about their condition. The problem also affects 20% of those with bipolar disorder. As a result, many of them either refuse to take medication or stop taking it abruptly.
These situations are everyday among people with psychiatric disorders, but can also affect those suffering from other conditions. For example, people with hemiplegia (one-sided bodily paralysis) or hemisensory loss (loss of vision or hearing on one side) may deny that anything is wrong with them.
When people are convinced they don’t need their medicines or feel their symptoms have improved, they may go cold turkey without consulting their doctors.
Some researchers feel that such resistance may originate from degenerative brain diseases or damage caused by conditions like strokes and seizures.
Some people also hesitate to take medicines because they doubt their safety and efficacy. A 2023 BMC Nephrology study found that a third of respondents felt that physicians overprescribe medication, which triggers non-adherence. Many also find the symptom burden overbearing, especially regarding tiredness and trouble sleeping.
Medication Adherence and Alternative/AI-Driven Advice
People who strongly advocate for complementary or alternative approaches like homoeopathy may also be uncomfortable with conventional medicines. This is even though many regulatory bodies, including the NHS and the FDA, have stated that homoeopathic products are a placebo. They have not been reviewed for medical effectiveness.
The risks of unsafe health behaviours are higher in an AI-dominated world, as many of us rampantly use ChatGPT and similar tools for self-diagnosis. A Futurism feature highlights how the obsession with ‘AI therapy’ is leading to dangerous behaviours like stopping medicines that have long managed health conditions, from anxiety to bipolar disorder.
It brings to mind the infamous case of Australian blogger Belle Gibson, who claimed to cure cancer with coffee enemas and juices. Eventually, it came to light that she had been feigning her diagnosis and was never ill to begin with.
Juice diets and coffee enemas have not been established to have enduring health benefits. For example, Mayo Clinic warns that juice cleanses don’t provide adequate nutrition and are ineffective at sustainable weight management. Even if you support alternative approaches, grandiose claims linking them to curing life-threatening diseases like cancer should be received with a massive grain of salt.
If you feel unsure about the medication your doctor has prescribed:
- Request a detailed conversation about the specific drug, including its effects, possible interactions, and timeline for working. You can also inquire about its side effects and if you can stop taking it if you experience discomfort.
- You can get a second opinion. You can also consult with professionals you trust, such as family members who are doctors.
- Stay away from AI-based tools for discussing medication or treatment plans.
- Approach any alternative treatments with caution and never without getting your medical team’s approval.
- Ask yourself if your resistance to medication has a deeper cause, such as denial of your condition or feelings of paranoia about the healthcare system. Professional therapy can help address negative or obsessive thought patterns.
The important thing is to draw a line between scepticism and denial, and do what your body needs for recovery.
Final Word
Adhering to a medication routine can be challenging, more so for some of us. For optimal recovery, it is advisable to follow the prescribed plan and dosage. The adherence strategies we discussed above should help you follow the plan without getting sidetracked.
If you still find yourself missing medication or not following the recommended routine, speak to your doctor for help. They can simplify the plan or adjust areas you are struggling with, such as medicines you have to take after dinner or first thing in the morning.
Thanks to evolutions in medical science, we now have treatments for health conditions that were previously incurable or unmanageable. However, taking responsibility for your healing is essential to benefit from these developments.