Seniors Struggle with Medication Adherence

The legendary movie star Bette Davis famously said “old age ain’t no place for sissies,” and there is no place where this is more true than in healthcare. The situation for seniors may be improved now with Medicare and its expansion, but getting treatments covered is just the beginning of the wellness process.

Adhering to a complicated regimen of drugs can prove difficult for anybody, but it is especially hard for seniors to manage multiple prescriptions with different requirements and dose frequencies. The New York Times recently reported on the difficulties seniors faced with research studies that confirmed expert suspicions that seniors are failing to properly take their prescriptions.

One study took a group of people aged 55-74 and gave them different medications to be put into a pill organizer and measured their outcomes. Their success was limited.

“Ideally, the seven meds could have been grouped into just four dosings per day. But only 15 percent of the 464 subjects grasped that possibility. Most commonly, they decided they needed to take pills six times a day; one-third organized the pills into seven daily doses.”

Without a roadmap the vast majority of patients are not capable of organizing their pills. Medication adherence is the technical term for properly administering one’s prescriptions. Seniors take more drugs than any other group and the more pills that a patient takes the lower their adherence numbers. In the study 80% of subjects failed to realize they could take 2 medications at the same time; the instructions were “take twice daily” and “take every 12 hours.” When a person fails to take their medication properly, the impact on their health can be severe.

In many cases when a patient is taking multiple medications they are seeing more than one doctor. It can be very confusing for a doctor after writing prescriptions to treat an ailment but the patient is still experiencing symptoms. But if the patient is not taking their medications properly and their doctor is not aware, than their health problems could be greatly exasperated.

“Drug A seems ineffective, leading a physician to add Drug B, when the real problem is that the patient simply misunderstood the dosage and wasn•t taking enough A. Or an older patient simply throws up his hands over a complex regimen and remains unmedicated or undermedicated, risking serious illness.”
The people most at risk of failing medication adherence are those who may be suffering from mental impairment or those taking the most complex array of pills. Even the look, shape and color of a pill affects adherence and if the look changes there can be consequences.

“Those cosmetic alterations led to trouble. While most patients stuck to their regimens, those whose pills changed color were 34 percent more likely to stop taking them, compared with a control group. When the pills changed shape, patients were 66 percent more likely to discontinue using them.”

Missing a dose or confusing a couple pills could seem to be a small problem, but the public health implications can be very real. Private insurers have introduced Medication Therapy Management which is a program that helps a patient with multiple conditions and prescriptions stay organized, review details, and answer questions. If a private insurer is spending up front then it must be saving them money in the long term. Medicare would greatly benefit from a similar program that could save taxpayer money. Millions of seniors are at risk and they need help managing their medications to ensure they are on track to maximize healthy outcomes.