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  • With Mayo Clinic diabetes educators

    Nancy Klobassa Davidson, R.N., and Peggy Moreland, R.N.

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  • Living with diabetes blog

  • Feb. 27, 2013

    Diabetes: Drugs only work if you take them

    By Nancy Klobassa Davidson, R.N., and Peggy Moreland, R.N.

12 comments posted

Controlling Your Diabetes

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"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,

Nancy

12 comments posted

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  • March 20, 2013 1:04 p.m.

    My pill organizers are stacked right next to my blood testing meter at the kitchen table. When I open the fridge, the first things I see are my insulin pens. My morning Metformin is right next to the handle of the fridge door. I bought an extra blood-testing kit for at work -- it's in the same bin as my car keys, next to the phone. If I go out to lunch, I grab the kit. If I eat in, I see the kit and test. I bought 2 weekly pill organizer boxes. I set up two weeks' worth at a time. All of these steps help me remember to stay on track.

    - Linda

  • March 18, 2013 6:10 p.m.

    Set my I-phone alarm to remind me to take my evening meds, which I always forgot. I have to get up, find the phone, and turn off the alarm so I take the med while I'm up.

    - Linda

  • March 7, 2013 11:06 a.m.

    I leave my pill box out on the kitchen counter in plain sight as a reminder. But sometimes I forget to take the pill box out of the cupboard.

    - Gary

  • March 7, 2013 6:16 a.m.

    with everybody using mobile phones, one could feed the name of the medicine and the time at which to take as a to - do list item in the ohone with a alam tone.

    - s radhakrishnan

  • March 6, 2013 4:16 p.m.

    Currently I take 12 pills a day plus an insulin shot before bed. Biggest problem overall is, "I remember taking this pill, but was that yesterday?" That's when I started with the dumb (but useful) pill organizer. Recently, I had two generics that looked the same, one taken early morning, and the other before bed -- not good to mix them up, not at all. So I moved to two pill dispensers, at least temporarily. Recently added a pill before lunch, and that's the one I forget most often now. I find that one very hard to remember, because remembering after three mouthfuls is too late to take it. (Past experience tells me it may take two weeks, or three, before I remember to always take this pill.) For me, keeping the pill organizers on the table where I eat is critical to remembering to take the pills. I also have a paper cup of water on the table, an additional reminder to take pills after that meal.

    - Ginger

  • March 6, 2013 11:35 a.m.

    An inexpensive watch with alarm is quite helpful!!!

    - Eva

  • March 5, 2013 3:36 p.m.

    I use pill organizers. I fill three of them at a time so my meds are always ready, and put today's segment of the one that comes apart out on the kitchen counter near the sink. I can see whether I have remembered.

    - Yvonne

  • March 5, 2013 2:41 p.m.

    It boggles my mind that people forget to take their meds. I take mine at breakfast,supper and bedtime and it's a habit like eating. It's important to take meds that are prescibed and important to follow orders. I'm not interested in having problems with my diabetes due to not taking my meds.

    - Ferne

  • March 5, 2013 2:27 p.m.

    I have a problem with Onglyza. At the time it was prescribed I didn't realize that it is: - a DPP-4 inhibitor that, with my other cancer risk factors, I am not comfortable taking - Not a very effective drug (much less effective than the metformin I already take) but is a very expensive drug (which I was unprepared for) My other drugs; yes I sometimes forget. If you can forget your drugs you can also forget memory aids, calendars, drug organizers etc.

    - Chris

  • March 5, 2013 1:17 p.m.

    I have crohn's disease and the meds for type 2 make me very sick. I go into a flare. My Dr does not understand that I just can't take the meds.

    - Suzie

  • March 5, 2013 11:49 a.m.

    I remember to take my diabetes meds because I've attached a great importance to them. I was diagnosed with type II when I lost my eye sight for 6 weeks when my blood sugars were soaring. I vowed that wouldn't happen again. I also keep the meds on the counter near my food prep so that I can see them and know to take them after breakfast and after dinner.

    - Dina

  • March 5, 2013 11:29 a.m.

    if i take my glucophage at 5am must i take it at 5pm or does it not matter as long as i take it twice a day. i normally take it just before breakfast which is 6am and at night it varies by about half an hour, either 6pm or 6.30pm. it is well under control reading between 4.6 to 5.2 2hours after breakfast and supper.

    - Isabel

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