- With Mayo Clinic diabetes educators
Nancy Klobassa Davidson, R.N., and Peggy Moreland, R.N.read biographyclose window
Nancy Klobassa Davidson, R.N., and Peggy Moreland, R.N.Nancy Klobassa Davidson and Peggy Moreland
Nancy Klobassa Davidson, R.N., B.S.N, C.D.E
Nancy Klobassa Davidson is a registered nurse who has worked in diabetes education for 17 years. She is a certified diabetes educator (C.D.E.) and is currently in graduate school working on a Master of Science in nursing (M.S.N.) and health care education.
Nancy works with adults who have type 1, type 2 and other forms of diabetes. Nancy is coordinator of the Diabetes Unit's intensive insulin therapy program within the Division of Endocrinology, Diabetes, Metabolism, & Nutrition at Mayo Clinic in Rochester, Minn. Nancy has worked extensively with insulin pump therapy and continuous interstitial glucose sensing.
Peggy Moreland, R.N., M.S.N.
Peggy Moreland is a certified diabetes educator (C.D.E.) in the Division of Endocrinology, Diabetes, Metabolism, & Nutrition at Mayo Clinic in Rochester, Minn.
Peggy graduated with a Master of Science in Nursing and Health Care Education from the University of Phoenix and is a member of the American Association of Diabetes Educators and the American Diabetes Association. A certified diabetes educator (C.D.E.), Peggy enjoys working with patients to set and achieve diabetes self-management goals.
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Diabetes: Drugs only work if you take them
By Nancy Klobassa Davidson, R.N., and Peggy Moreland, R.N.
"Patient compliance," "medication adherence," "medication non-adherence" — these are a few terms used to describe when people fail to follow their medication prescriptions. Medication non-compliance is the failure to take drugs on time in the dosages prescribed. It's a common problem. According to an April 2011 Mayo Clinic Proceedings article, only about half of those who are prescribed medication take it exactly as prescribed.
I've been told at continuing education conferences that there's no such thing as a "non-compliant" patient and to avoid the label. Such labeling is loaded with implications and stereotypes. Most of us want to follow our health care provider's advice so why are so many of us not taking our medications as prescribed?
As it turns out, there are many reasons you might not take your medication as prescribed. They include not understanding medical terms, not being involved in the medical decision making, poor communication on the part of your health care provider, your doctor having an incomplete medical history, limited finances or access to health care, complex medication regimens, cultural barriers, memory issues, health beliefs or misconceptions and many others. It's a complex issue with no single solution.
In a 2003 report on medication adherence, the World Health Organization stated, "Increasing the effectiveness of adherence interventions may have a far greater impact on the health of the population than any improvement in specific medical treatments."
Wow, so what can be done? Some possible interventions include:
- Patient-education classes
- Providing interpreters for foreign speaking individuals
- Simplified medication programs
- Empowering people to self-manage chronic diseases
- Written instructions or pictures specific to a person's literacy level
- Provider consideration of economic constraints
- Appropriate follow-up care
These are considerations for your health care provider, but what can you do?
First, ask questions. You have the right to understand your own medical program. And consider inviting a family member or friend to your appointments, to assist with understanding instructions.
I also commonly hear: "I just keep forgetting to take my medication, and some times are harder to remember than others." Taking medication is a behavior, and all behaviors can be changed, although change isn't always easy. Consider tools designed to help — such as medication organizers, dispensers, pill box timers, alarms and written schedules or calendars — available in a range of prices.
How do you remember to take your medication? Please share your thoughts.
Have a great week,