With so many things to remember from day to day — birthdays, doctor appointments, bill due dates — it’s no wonder we sometimes slip up and forget to take our medications. In fact, medication adherence, which means taking your meds as prescribed, is a big issue in the United States. About one in five prescriptions are never filled at the pharmacy, according to the Centers for Disease Control and Prevention (CDC).1 And even when they are, about half the time they’re not taken correctly.
“There are a host of reasons why many people, especially older adults, struggle to stick with their medication regimen,” explains Michael Hochman, MD. He’s an associate professor of clinical medicine at Keck Medicine of USC and host of the Healthy Skeptic, MD podcast. “The reasons range from cost to fear of side effects to just not understanding why they’re needed.”
But if you don’t take your medications correctly, you’re putting your health at serious risk: An estimated 125,000 deaths in the U.S. each year are due to poor medication adherence.2 If you have a chronic illness and don’t take your medications like you are supposed to, your risk of hospital admission increases as much as 69 percent, according to the CDC.3
If you do struggle to take your medications, it’s important to be honest with your doctor. Don’t worry that they will judge or scold you — it’s a common problem, says Dr. Hochman. But if you’re not honest, you and your doctor can’t work together to come up with solutions. Here are six possible ones to try.
1. Do a medication review.
Two-thirds of older adults rely on at least two prescription drugs, according to a 2020 poll done by the University of Michigan’s Institute for Healthcare Policy and Innovation.4 And two out of 10 older adults regularly take at least five prescription meds.4 “We know that the more drugs older adults take, the lower their medication adherence,” says Dr. Hochman.
However, up to 60 percent of drugs prescribed to seniors may not be necessary, reports a 2020 study published in the journal Therapeutics and Clinical Risk Management.5 That’s why it makes sense to find out whether you really need to keep taking all your current medications, or if something might have changed. For instance, maybe your health has improved enough to stop taking a drug, or perhaps one of your medications is doing the job of two.
To find out more about your medications, ask your care team about the Medication Therapy Management program, which helps you and your doctor manage your medications. If you qualify for the program, a pharmacist will do what’s called a “brown bag” medicine review. That’s when they review all your medicines to make sure you’re taking the right ones at the correct dosages. During the review, you can go through each one and talk about any questions or concerns you have.
Questions about your medications? Aetna® Dual Eligible Special Needs Plan (D-SNP) members can get personalized answers from their care team. Visit AetnaMedicare.com/DSNPInfo to learn more about D-SNP plans.
2. Ask about cheaper options.
Almost 30 percent of Americans report that they haven’t taken a medication as prescribed at some point because of cost, according to the Kaiser Family Foundation.6 If you’re struggling to pay, start by checking the cost of your medications. You can look them up in your formulary, also called a drug list.
Your formulary will tell you which tier your medication is in. In general, the lower the tier, the less you pay. Once you know the tier and price, talk to your doctor about the best, lowest-cost prescriptions for you — there may be a cheaper alternative in a different tier.
Also, if you are taking any of your medications long-term, think about getting a 100-day supply. This can save you money as well as time, since you only refill your prescription once every three months. .
Most Aetna D-SNP members can get up to a 100-day supply of medications they take regularly to maintain their health. Visit AetnaMedicare.com/DSNPInfo to learn more about D-SNP plans.
3. Let your doctor know about side effects.
“Side effects — either fear of them, or actually experiencing them — is one of the biggest reasons my patients stop taking their medications,” says Dr. Hochman. A 2017 national survey found that almost 30 percent of people who stop taking a drug without talking to their doctor do so because of side effects.7
If you are having drug-related side effects, your doctor may be able to change the dose. Or they can switch you to a different class of medications to solve the problem. But sometimes what seems like a side effect, like headaches or weight gain, isn’t related to the medication, Dr. Hochman adds. “It’s always important to talk to your physician. They will be able to connect the dots — and find potential solutions — more easily than you can.”
4. Keep a medication chart.
There are plenty of smart phone apps and gadgets that can help you remember to take your meds. But a simple medication chart tacked to your fridge often does the trick, says Hochman. Write on the chart when to take each medication (say, morning or at night), the dose, and a quick reason why you are taking it.
“I find the reason is particularly helpful for people who are taking medications for something that may not actually cause symptoms, such as high blood pressure or cholesterol,” says Dr. Hochman. “It reminds them that even though they feel fine now, these drugs are to keep them healthy and prevent health issues down the road.”
5. Pick up a pill organizer.
The U.S. Food and Drug Administration recommends that you use an organizer for all your medicines. Some have sections for multiple doses at different times of day (such as morning or evening). Some even have timer functions, so they can remind you to take a dose.
It’s also a good idea to place pill organizers in a visible spot to jog your memory when you see it. Think about timing, too. If a drug needs to be taken with food, place it on the dinner table or TV tray. For those that need to be taken in the morning, put them in the bathroom next to your toothbrush, or in the kitchen beside the coffee pot.
6. Choose the easiest form of medication.
If taking pills is not your favorite, you’re not alone: Up to 40 percent of all adults find it hard to swallow pills.8 It can be especially hard if you have a condition that can affect your ability to swallow, like dementia or a stroke. One trick is taking a pill in applesauce or yogurt. The added texture can make it easier for you to swallow, says Hochman.
If that’s not working, ask your pharmacist or doctor if you can crush the pill or split it to make it smaller and easier to wash down. (It’s important to never crush a pill without asking your provider first. If the medication is extended release, you may get too much of the medication at once.)
Another option is to take a liquid version, if it’s available. If it’s an over-the-counter (OTC) medication, you might try the children’s version. Just be sure to talk about it with your pharmacist beforehand so they can help you figure out the conversion dose.
Most Aetna D-SNP members get a quarterly allowance to buy certain OTC health and wellness items like pain relievers. Visit AetnaMedicare.com/DSNPInfo to learn more about D-SNP plans.
1Centers for Disease Control. CDC grand rounds: improving medication adherence for chronic disease management — innovations and opportunities. Morbidity and Mortality Weekly Report (MMWR). November 2017. Accessed June 13, 2022.
2Kleinsinger F. The unmet challenge of medication adherence. The Permanente Journal. July 2018; 22: 18-033.
3Centers for Disease Control. Overcoming Barriers to Medication Adherence for Chronic Diseases. Public Health Grand Rounds. February 2017. Accessed June 13, 2022.
4Coe A, Farris K, Malani P. University of Michigan Institute for Healthcare Policy and Innovation. Clashing medications can put older adults at risk, but many haven’t had a pharmacist check for safety concerns. October 2020. Accessed June 13, 2022.
5Rahman S, Singh K, Dhingra S, et al. The double burden of the COVID-19 pandemic and polypharmacy on geriatric population — public health implications. Therapeutics and Clinical Risk Management. October 2020; 16: 1007-1022.
6Kirzinger A, Lopes L, Wu B, et al. Kaiser Family Foundation. KFF health tracking poll — February 2019: prescription drugs. March 2019. Accessed June 13, 2022.
7Hobson K. NPR. Why do people stop taking their meds? Cost is just one reason. September 2017. Accessed June 13, 2022.
8Forough AS, Lau ETL, Steadman KJ, et al. A spoonful of sugar helps the medicine go down? A review of strategies for making pills easier to swallow. Patient Preference and Adherence. July 2018; 12: 1337-1346.