What if you heard of an epidemic that was causing up to 125,000 deaths each year in the U.S.? What if this epidemic was also responsible for 10 percent of all hospitalizations in the country, and was costing the American health care system well over $100 billion annually? And what if you discovered that this epidemic was almost entirely preventable?
We suspect you’d be shocked, and so were we when we read this very recent article in the New York Times. Written by nationally known health columnist Jane E. Brody, the article is titled “The Cost of Not Taking Your Medicine,” and it reveals that this serious national health epidemic has a name: nonadherence to prescribed medications. Yes, that’s correct, all those deaths, hospitalizations and horrendous costs are the result of people who refuse to do what their doctors tell them to do, often with devastating consequences.
“The numbers are staggering,” Brody writes in the New York Times. “Studies have consistently shown that 20 percent to 30 percent of medication prescriptions are never filled, and that approximately 50 percent of medications for chronic disease are not taken as prescribed.” That, she says, is according to a review in Annals of Internal Medicine. Brody adds, “People who do take prescription medications — whether it’s for a simple infection or a life-threatening condition — typically take only about half the prescribed doses.”
(By the way, before you think more-compliant seniors are better at following doctors’ orders, think again. The Department of Health and Human Services reports that 55 percent of the elderly are what’s called “non-compliant” with their prescription instructions, which simply means they’re not doing what their doctors tell them to when it comes to prescribed medications.)
This refusal to comply with prescription regimens applies across a full spectrum of patients and conditions. Brody writes, “Studies have shown that a third of kidney transplant patients don’t take their anti-rejection medications, 41 percent of heart attack patients don’t take their blood pressure medications, and half of children with asthma either don’t use their inhalers at all or use them inconsistently.” The article goes on to quote one expert, Denver physician Dr. Bruce Bender, who states bluntly, “When people don’t take the medications prescribed for them, emergency department visits and hospitalizations increase and more people die.” He calls prescription nonadherence “a huge problem, and there’s no one solution because there are many different reasons why it happens.”
So that brings up the question, “Why does it happen?” The reasons some people stop taking prescriptions, or never start in the first place, are varied. Among seniors, DSHS says factors such as mental decline, confusion about instructions, or isolation that leads to self-neglect can all play a part. But for the general population, people have plenty of different excuses. High cost, either direct cost or co-pays, can contribute to people stopping their medications. Some people dislike particular drug side effects, or they decide on their own to opt for a “natural” treatment instead of the physician-prescribed drug. Frequently, says Denver’s Dr. Bruce Bender, patients try their own experiment: “People often do a test, stopping their medications for a few weeks, and if they don’t feel any different, they stay off them. This is especially common for medications that treat ‘silent’ conditions like heart disease and high blood pressure. Although the consequences of ignoring medication may not show up right away, it can result in serious long-term harm.”
So what’s our reaction to the Jane Brody article? We agree with the quote from former U.S. Surgeon General C. Everett Koop, who said “Drugs don’t work in patients who don’t take them.” But we also share a certain skepticism about the argument that says one more pill or one more prescription is always the best solution to a medical problem. Our recommendation here at AgingOptions is that senior adults ought to place themselves under the care of a board-certified geriatrician, or geriatric physician, who is trained to understand the unique medical needs of older patients. We know from personal experience of geriatricians who have taken patients off of certain prescriptions when other doctors may have over-prescribed certain drugs or given their patients drugs that actually counteract each other. Please contact us during the week and let us recommend a geriatric physician in your area. (And remember, you should never stop or adjust a prescription without appropriate medical supervision – the results could be catastrophic for you or your family.)
So much for prescription drugs: now, what’s our prescription for a healthier retirement? Here at AgingOptions we prescribe a uniquely powerful and comprehensive solution to the challenge of retirement planning called a LifePlan. An AgingOptions LifePlan takes all the vital elements of your future planning and weaves them together into an interdependent whole: your finances, your legal protection, your health care needs, your housing choices, even communication with your family. With a LifePlan in place, you have the blueprint you need to build the retirement you’ve always longed for, one that’s rewarding, fruitful and secure.
There’s a simple way to find out more: attend a free LifePlanning Seminar. We offer these popular seminars at locations throughout the region, so click here for details, including online registration. You can also contact us during the week. We guarantee that you’ll come away with a fresh outlook on the process of planning for your retirement years. It will be a pleasure to meet you soon at an AgingOptions LifePlanning Seminar. Age on!
(originally reported at www.nytimes.com)