Medication Adherence in the 21st Century: Ways to Make Your Life Easier!

As a physician who treats children with complex lung disease, I have often been frustrated when patients and their families fail to follow recommended treatment regimens. I guess it’s often easier for physicians to blame the family, than to take the time to identify the barriers to care that led to the lack of compliance in the first place. It took me a long time to realize this, but helping to educate families about ways to overcome these obstacles really makes for a better patient-physician relationship. We are fortunate to have some great tools to help our patients manage their medications. Here are some tools and tips to help you address common issues with medication adherence.

“I forgot”  What you need are medication reminders:

• Simple medication alarms/alerts can be set on any cell phone.
• Free pill reminder apps are available on all app based phones. I like Pill Reminder by Drugs.com for the iPhone as you can also set refill reminders, but patients with other devices have successfully used other apps such as the Google Play Pill Reminder.   The bottom line is pick one and use it!
• Electronic pill dispensers can help sort multiple pills.
• When in doubt, place your meds next to your toothbrush, phone, wallet or whatever item you don’t leave home without! Although if you have little ones around make sure it’s out of their reach.

“It takes too long”  You need better devices:

• Every inhaled steroid comes in an inhaler form, taking seconds to complete.
• Podhalers® can now deliver inhaled antibiotics (tobramycin) in 60 seconds instead of the usual 20 minutes!
• Exercise and sports activities can take the place of traditional airway clearance (chest percussion, vest, etc), just ask how to make this an effective part of your routine!
• Some antibiotics can be instilled directly into tracheostomies and we have connections for inhaled medicines directly into ventilator circuits.
• Utilize your social media community for support, but remember to check any information gathered with your medical team for accuracy.
• Help your child make games out of his or her medications. A nebulizer is a lot less scary if it looks like a favorite animal!

“It costs too much” Tricky, but manageable:

• Ask about drug discount programs. For diseases such as cystic fibrosis, many chronic medications have discount programs that can drastically cut costs or even provide free drugs.
• Ask about generic equivalents. Some may exist and have equal efficacy, but you must be careful and work with your physician team when choosing a generic brand.
• When in doubt, ask to speak to a social worker, they are a wonderful resource.

“I have too many medicines” This is probably our fault:

• Providers need to give you education on what each medicine is for.This takes an honest two-way communication regarding what medicines you use and how often.
• Look to simplify regimens through combination drugs.Free drug apps for mobile phones explaining side effects, interactions, etc.
• Create a medication grid so your provider can see your true burden of treatment and assess for simplification.