‘A Spoon Full of Sugar’ Part 2

Welcome to part 2 of a challenging, health-impacting (sometimes life-threatening) issue – medication adherence. In layperson’s terms, medication adherence refers to just how closely a patient follows the medication routine their health professional has prescribed. In part 1 we checked out the reasons why medication adherence can be a challenge for some patients. Now, we look at the personal consequences and wider ramifications of medical adherence issues.

The silent epidemic

Medication adherence has undergone a number of name changes over the years. Once referred to as ‘medication compliance,’ it is now more likely to be known as ‘medication implementation,’ or ‘medication concordance’ – terms which are less authoritarian, accusatory, and blaming of patients. Unfortunately, whatever it’s called, the failure of a well-informed patient to carry through the recommendations of their trusted medical provider, can cause very serious health outcomes. So much so, it has been referred to as a ‘silent health epidemic’ and it has downstream consequences for almost everyone.

Pressure on health services

Medication adherence issues lead to hundreds of thousands of hospital admissions each year. Patients are occupying hospital beds and contributing to extended waiting times in medical centres and Accident and Emergency rooms, at a time when staffing in public hospitals is at crisis levels. As well as taking up GP services and hospital time, medication non-adherents also put pressure on diagnostic centres and laboratories. This causes delays for other patients, some of whom may opt to pay for private services such as blood tests and scans. If medical adherence issues lead to a serious decline in a patient’s physical and/or mental health, residential care may be required, and at a time when there is already a serious shortage of beds in such facilities.

Family pressure

A patient’s failure to take medication as prescribed can increase the burden placed on the family members and friends who provide them with care and support. There is an emotional burden on these support people as they watch their loved one’s health deteriorating. There is considerable stress on family and friends when they are required to take time away from their immediate family or jobs to provide care, help the patient get to appointments, and visit them in hospital. Economic and emotional burden soon impacts the lives, not only of medication-non-adherents, but of those in their family who care for them. Before long, these family members’ own quality of life begins to deteriorate.’ 

Quality of life

Medication adherence issues can quickly lead to a lower quality of life in patients. A build-up of drug-resistant bacteria, worsening conditions and symptoms, disease progression, and unnecessary increases in medication, all contribute to a patient’s poorer health outcomes. To bring home the seriousness of non-adherence to medication, consider these case scenarios:

•      A glaucoma patient who misses doses of medication can suffer optic nerve damage and blindness.

•      A patient with heart disease can develop erratic heart rhythm or experience cardiac arrest.

•      A patient with high blood pressure can face a stroke.

National economic burden

Medication adherence issues continue to burden not only our health system, but the country’s economy in general. Whether it is through wasted medication, the need for more professional caregivers, or additional infrastructure such as new care homes and hospitals, our taxes will only stretch so far in providing these. As private health insurance feels the cost of medical adherence issues, their premiums rise in response.

While no one is blaming a patient for difficulties in adhering to prescribed medications, an understanding of why these issues occur, and the toll they take, can help us all to be more vigilant. In our next article, we’ll be looking at ways in which we, and those we care for, can work toward overcoming the challenges of medication adherence – so we can all hope for a better quality of life.