The biggest step in medication safety is also a surprisingly simple one: actually filling the prescription and taking the medication; and yet, research indicates that more than 60 percent of cardiovascular patients do not take their medication as prescribed. Failure to take medication properly is called non-adherence (or noncompliance). Non-adherence includes --
- never filling prescriptions,
- not picking up prescriptions,
- not starting the medications, or
- not following dosing instructions.
Patients may use any number of common excuses for failing to take medication. Ultimately, there are no good excuses when your life is on the line. Among heart attack patients who were discharged from the hospital, those who filled none of their prescriptions within 120 days had 80 percent greater odds of death than those who filled all of their prescriptions. That's just one example.
Answers to Common Reasons Patients Give for Non-Adherence
Here is a list of common reasons patients give for non-adherence:
“I Feel Better, So I Do Not Need Medication”
Always check with your doctor before you stop taking medication. If you are a cardiovascular patient, your medication serves both maintenance and prevention functions. Going off antiplatelet medication, for example, could allow blood to clot, causing a new heart attack or stroke.
“I Do Not Feel Better, So Clearly the Medication Isn’t Working.”
Just because you cannot feel a medication working does not mean it is not doing its job. Some important medications are not going to change the way you feel, but they will affect your chances of having a heart attack or stroke.
You should not ignore any news you hear, but you also should never stop taking a prescribed medication without talking to the doctor who prescribed it. Part of being an informed patient is paying attention to new information about any medications you are on. If you see a news headline that worries you, or your dentist or another provider asks you to stop a medication in advance of a procedure, call your cardiologist who prescribed the medication. This is especially important if you have a stent and are on dual antiplatelet therapy (DAPT). Your interventional cardiologist knows if it is safe for you to stop the DAPT even briefly. If your cardiologist disagrees with having you stop a medication for a procedure, he or she can call the other provider and discuss the best options for you.
And, if new research indicates that the medication is not the best option for you, it is likely far more dangerous to suddenly stop taking the medication than to take a few more doses while you seek additional information from your physician.
“I Cannot Afford Medication.”
Never try to economize by skipping some doses or taking a portion of a dose. Doing so can be dangerous. The cost of medication is a legitimate concern, but it cannot stand in the way of you taking care of yourself. If you are worried that you will not be able to pay for your medications, talk with your doctor. Your health is more important than any unnecessary sense of shame you may feel. Your doctor may be able to switch you to a cheaper medication, or refer you to a service or social worker who can help you find ways to afford your medication. See How to Afford Your Medications for more information.
“I Simply Forget to Take My Medications.”
Remembering to take medications can be difficult, but the outcomes of not taking it are too serious. If you have trouble remembering to take your medication, write down a list of medications and dosing information or mark the information on your calendar, enlist the help of family or friends, or use a service such as automated phone reminders or an electronic pill box that notifies you when it is time to take your medication. See Know Your Medications and How to Take Them for more information.
“I Do Not Want to Take a Lot of Medications.”
Taking your medication can be the difference between life and death. No one wants to take a lot of medications. But taking them could save your life. If you have any questions about the number of medications that you are on, talk with your doctor to make sure they are all necessary.
Side Effects and Interactions
If a medication makes you feel bad in any way or affects your ability to function as you normally would, DO NOT stop taking it but DO tell your doctor. Medication is a critical part of your treatment and your doctor will work with you to alleviate the side effects by adjusting the dosage or trying a different medication.
To learn more about side effects and interactions, click here.
Stay in Touch with Your Healthcare Providers
The most important thing to remember about medication is to take it as directed by your doctor or other healthcare provider. Even if you feel great, hear something negative about it on the news, or another doctor tells you to stop taking it before a procedure, check with your doctor first before you reduce or stop taking your medication. Click here for some common questions that you might find helpful when you discuss your medication with your doctor.