Medication Adherence

Medication non-adherence is defined as not being able/willing to start, continuously take, or prematurely stop taking the prescribed medication.

A growing number of medications prescribed for a variety of cancer types are now being self-administrated at home, either by mouth or as an injection. These medications are taken to reduce the cancer recurrence risk and/or to treat cancer cancer.  These medications only work when they are taken as directed. Rough estimates for chronic diseases in general project that only half of all patients take their medications as directed. These same numbers also seem to include cancer medications. Additionally,  adherence to non-cancer medications for chronic disease may also drop in the first year following cancer treatment.

Reasons for non-adherence can be multiple:

• Logistical barriers, such as access to a pharmacy, insurance coverage and affordability, and difficulties in obtaining refill requests.
• Change in an individual’s belief of the benefits and risks of continuing cancer medications.
• An individual’s ability to tolerate side-effects.

You may feel embarrassed to tell your doctor that you are not taking your medications in the manner they were prescribed. Keep in mind that everyone’s personal circumstances and drug kinetics differ. Cancer medication only works as well as you are able to take it, and not being able to follow your care plan may make you concerned about the cancer treatment’s ability to control the disease.

Life happens, and sometimes we all miss a scheduled dose. It is probably okay; check with your provider or the drug reference materials provided by your pharmacist to determine what you need to do (i.e. skip the dose, catch up on a dose, etc.). It is a great idea to make use of a daily pill box. It gives you visual proof of whether or not you have already taken, or still need to take your prescription.

If you find that you have consistent issues with not being able or willing to take your medications, then you should talk with your provider so that he (or she) can help you find a solution that works. Your provider may recommend remedies to allow you to tolerate it better, changes of the dosage, frequency, or delivery method of your medication, or even switch to another medication. It is never recommended that you experiment on your own by adjusting the dosage. Talk to your provider!

The power of suggestion can be strong! Sometimes, selecting a start date may allow you to prepare yourself physically, mentally, and spiritually and develop a positive and focused approach to a new treatment course.

Adherence to your medication regime is recognized as a challenge by the medical community. Finding the right solution is often a very individualized approach that requires open communication between you and your provider. Remember that these challenges are not unique to you alone and that  remedies that optimize medication adherence are being explored on many levels. If you would like to contribute, you may want to explore research studies available near you that seek to find interventions at the patient level that support medication adherence.