Wellness: The Doctor is In – Medical Misuse

Herbert Weinman, MD, MBA - MAY 05, 2017
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Properly prescribed and administered medication plays an important role in protecting, maintaining, and restoring health. The benefits of drug therapy are unquestionable, and when used appropriately should maximize benefits and minimize unwanted side effects.

When prescribing drugs, physicians and patients should ask: What is the most cost- effective and simplest regimen? Is there an understanding of all aspects of treatment? This is all the more important when we realize that approximately one-third of all prescribed medicine is taken improperly, and a large percentage of hospital admissions are the result of improper use of medication.

Statistics concerning medication noncompliance are both enlightening and frightening. In general, 40% of patients will skip doses for greater than two days of short-term therapy, 50% make mistakes in the timing of taking medication, 10% overdose, 100,000 prescriptions usually go unfilled or refilled, and 30% of patients will change doses on their own without consulting a physician.

The statistics for the elderly are even more staggering. Approximately 250,000 hospital admissions per year are due to drug misuse.

Taking medication improperly can result in dangerous outcomes, errors by physicians who assume the patient is taking medicine properly, accidental poisoning, and unnecessary hospitalization, treatment, and diagnostic costs.

In terms of improving patient compliance, I think one of the most important aspects is for the patient and the physician to understand the differences, attitudes, and concerns about taking prescription medication.

It is important to know that patients are busy and have a life other than dealing with their illness. In fact, many people don’t take their medicine properly because they subconsciously don’t want to acknowledge their illness. Patient compliance will improve by keeping the regimen simple, making sure that the least expensive and most effective medicines are prescribed, and using special patient-friendly reminder aids.

Forothersolutionstopatient noncompliance, I suggest that physicians give simple instructions and have the patient repeat them before leaving the office. If the patient is not completely mentally competent, dispensing advice should be done in the presence of a family member or friend (a medical advocate).

Patients should be encouraged to ask questions and should bring all of their medications to the physician’s office at each visit so that the physician will know what medicines they are taking and how many doses they have left. Patients should check expiration dates on medicines, avoid sharing prescriptions with family and friends, and keep all medications in a safe place.

Finally I believe one of the most important aspects of prescription dispensing and utilization is the relationship that exists among the patient, the physician, and the pharmacist.