Medication Adherence

Amit Kapoor, M.D.

Excerpt from Kapoor’s Korner:
A series of blog posts by Dr. Kapoor about the latest trends/topics/viewpoints in Nephrology and healthcare by Dr. Amit Kapoor.

Physicians will often talk to you about medication adherence or compliance. But what does that really mean for you? Objectively it means the extent to which you take medications that are prescribed by a provider relative to that provider’s recommendations. For a patient to be compliant with taking a medication, that means he or she objectively must be taking the pill at least 8 out of every ten times, the pill is prescribed over the lifetime of that prescription. Why is that important? Not taking pills as prescribed, will have serious long term consequences, including reduced quality of life, increased hospitalizations and length of stay in the hospital in each year and ultimately higher one year death rates compared to patients who are compliant. On average dialysis patients are on up to 12 medications a day, for the treatment of numerous underlying diseases, including, but not limited to bone disease, anemia, heart disease, diabetes, congestive heart failure and high blood pressure. The more complex the disease, the higher the likelihood of non-adherence. For our in-center patients that number can range from 30-80%, with an average of 50%. As you know there are several reasons for this. Among them are, the number of pills required to take in a day, the frequency of some pills, the potential drug- drug interaction, side effect profile (greatly impacting quality of life), cost, the lack of proper explanation as to the need and value of the medication and the harsh understanding that the medication prescribed can be lifelong.

It is important the Medical Director (or any healthcare provider) work closely with you in an empathetic way explaining the value to YOU of the medication being prescribed. By having all the information about a drug and the potential benefits and side effects, compliance will greatly increase. Seeing the positive effects the medication has on fellow patients can further enhance trust and participation in improving your care. Reviewing and updating (and hopefully simplifying) medications frequently with your provider, nurse, technician, dietician and loved ones in a team based collaborative way can significantly improve the quality and productivity of your daily life. Therefore, it is important we work as one team to help fix this growing problem

Posted in CKD Patient Education Blogs.