Missing your medicine dosage: should you be concerned or not?

Introduction

Taking the correct dosage of medicine at the right time is very important. Taking the medication on time is of utmost importance whether one is suffering from an acute infection or chronic diseases like hypertension or diabetes, as it is the reason for treatment success. But we are humans. We tend to forget. However, it can be costly to manage if one misses the medicine dosage. Non-adherence to prescribed medication can affect the quality of life. For example, by cutting a dosage of medicine, a person who has diabetes is at a higher risk for blindness or kidney failure or nerve damage.

In this article, let’s learn about the consequences of non-adherence to medication or missing a dose of medicine.

There are three types of medication non-adherence:

1. Non- fulfilment adherence – the patient does not initiate medicine intake.
2. Non – persistent adherence – patient stops taking the medication without informing their healthcare provider.
3. Non – conforming – patient behaviour affects the medication intake, like missing the dose, mixing up the timing of dosage, taking incorrect dosage etc.

The rate of adherence is the percentage of prescribed dosage taken by the patient over a given period. Patients having acute disease conditions are more adherent to the medication. According to various studies, patients suffering from chronic illness adhere to only 50 % of the medication prescribed to them.  Simpson conducted a meta-analysis of observational studies on the association between medication adherence and mortality. The observational studies included patients with heart disease, human deficiency virus infection and cardiovascular diseases other than myocardial infarction. It was observed that patients who adhered to medication survived longer than (1462 of 31439 = 4.7%) those who did not adhere (1371 of 15,408= 8.5%). A meta-analysis of 76 studies showed that 72% of the patients showed adherence to medication if it was supposed to be taken once. It reduced to 69% when medication was to be taken twice daily and 65% when medicines were to be taken thrice, and 51% when medicines were to be taken four times daily.

It might be challenging to track the impact of drug non-adherence. Most of the time, the doctor treating the patient is unaware of how the patient complies with the instruction.

The major consequences of missing medication are:

1. Wastage of medicines:

A randomised controlled trial found that 20-30% of medicine prescriptions were never filled, and 50% of the medicine for those who suffered from chronic health conditions was not taken as prescribed.

2. Symptoms of the disease may become severe:

Poor medication adherence results in a disease relapse or more severe symptoms. It is estimated that 13-52% of mental disorder patients cannot follow medication regimens.

3. Low quality of life:

According to a cross-sectional study conducted on outpatient diabetic patients of Multan province of Pakistan. Diabetic patients were older than 25 years and had the disease for more than a year. It was found that poor adherence to medication results in poor management of health conditions and increased cost of health expenses in patients with diabetes mellitus type 2. Thus it takes a toll on the quality of life of the patient and his family.

4. Increased out-of-pocket expenditure on hospitalisation:

A study that included countries worldwide looked at the association of prevalence rate hospitalisation with non-adherence. It was found that the rate of admission increased up to 10% approximately.

5. Increased mortality:

According to research, on average, about 1,25,000 deaths can be averted each year in the United States if patients with illness take the medication as prescribed.  Similarly, if a person suffering from Tuberculosis does not comply with the medication regime, it may result in relapse or a drug-resistant TB. It may even result in death.

However, adhering to medication can avert unnecessary deaths due to complications and out-of-pocket expenses for hospitalisation. According to WHO, If medication adherence is adequate, then it will have a positive impact on the health of the population than any improvement in medical treatment.  Compared to not taking medications as prescribed, good adherence was linked to a 21% lower risk of dying and a lower risk of hospitalisation by 17%.

How can we adhere to medicine dosage?

• We get a lot of medicine organisers in the market with days and times marked on them. You keep these medicine organisers handy.
• You can always set reminders on your smartphone.
• Keep your prescription and medicine in a place where you can locate it quickly. It should be visible and not out of sight.
• You can also upload your medicine prescription on Truemeds online pharmacy app or website and set a  reminder on the app or website to remind you to refill your medicines. 
• Try taking medicines daily around the same time, for example, before or after lunch.  
• If you have any medical prescription issues, you should always consult your doctor to understand the medication regime.

Conclusion:

If you are suffering from a chronic disease and want to understand how long you have to take the medication, then on Truemeds, you can get a free doctor consultation. On the other hand, if you want a reminder to refill the medicine, then don’t worry; Truemeds (app and website) will remind you to refill if you have uploaded the medicine prescription and set a reminder. You can order generic or branded medicine on Truemeds online pharmacy and get it free delivered to your doorstep anywhere across India. You can avail of up to 72% discount on your purchase.

Disclaimer– This content, including advice and medications, provides generic information only. It is in no way a substitute for a qualified medical opinion. Always consult a specialist or your doctor for more information.

References:

• https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3191684#r18
• https://pubmed.ncbi.nlm.nih.gov/12472330/