Take Your Medicine

November 25, 1993

One of the goals of the Clinton administration's health care reform effort is to help Americans take more responsibility for their own health. The pharmaceutical industry has one suggestion for doing that: Take your medicine. A task force funded by the industry has pinpointed what it terms a costly problem -- the failure of Americans to take their medicine as prescribed.

"Noncompliance," as medical professionals term the problem, can be as simple as skipping a dose of medicine or as serious as the spread of tuberculosis by patients who refuse to take the drugs prescribed. Noncompliance is a major factor in the failure of kidney transplants.

A survey by the American Association of Retired Persons found that 42 percent of Americans who are 45 or older say they do not fully follow their doctor's instructions on prescriptions. They may stop taking the drug before it runs out, take less than prescribed or never take the medicine at all. The results can range from costly relapses, hospitalization -- and, in cases like organ transplants, even death -- to relatively benign discomfort that nevertheless interferes with productivity.

Perhaps the task force's most important recommendation is better communication between doctors and patients. For instance, in several years working as a pediatrician in the South Bronx, Dr. Hazle Shorter found that by explaining to a mother the purpose and effects of a particular medication, the child was far more likely to get proper care.

The lesson holds true for pharmacists as well. Surveys have found that something as simple as having the pharmacist, rather than an assistant, hand the patient the prescription can increase compliance. That's not surprising. Trust is an important part of the healing process.

Prescription drugs play a big role in health care. Used properly, they can significantly increase the effectiveness -- and reduce the cost -- of care.

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