How Doctors Monitor if Patients Adhere to Drug Instructions

Research shows that, about half the time, patients don't take the medicine that is prescribed to them. There are many possible reasons why a patient might stop taking their medication. The patient may:

Believe that the drug can't help or wasn't needed in the first place
Worry about becoming dependent on the drug
Worry about the cost of the drug
Have side effects that seem worse than the problem the drug was supposed to treat
Have trouble swallowing the drug, or may be put off by the way the drug tastes or smells
Not trust the doctor who prescribed the drug
Have trouble remembering to take the drug
Feel like the condition is all done, and the drugs are no longer needed
Not understand the instructions for taking the drug

Whatever the reason, the patient stops taking their medication, the results can be very serious. For example, not taking drugs prescribed for a heart condition can lead to heart attack or stroke, and not taking drugs needed for glaucoma can lead to optic nerve damage and blindness. Not taking an antibiotic as you are prescribed can make the infection come back. Researchers even think that this may contribute to the rising problem of drug-resistant bacteria.

With all the damage that is done when a patient doesn't adhere to drug instructions, it is no wonder that doctors are very concerned about the subject and about finding ways to help patients get the drugs they need.

The simplest and most important way for a doctor to monitor the patient's adherence to drug instructions is to start each office visit off with what is known as a medication reconciliation. The patient is asked to list their medicines and then asked follow up questions, such as if the prescription needs to be refilled if there are any side effects, if another doctor has prescribed a new drug, and if the patient is able to afford the drugs that have been prescribed. And, most importantly, the patient should be asked if they are taking their medications as prescribed. The doctor should take this opportunity to stress to the patient how important it is to keep taking the drug as they were told.

Another way doctors can make sure the patient is following their instructions is by developing a good relationship with them from the first visit. Good old-fashioned communication is a great place to start to make sure the patient is doing what is needed to keep themselves healthy. If a patient has a good relationship with their doctor, it leads to trust, which means that the patient will trust the doctor when he tells them what medication they should take and why.

Good communication also means that the doctor spells out all there is to know about a medication before the patient ever starts taking it -- what it is meant to treat, what to expect when taking it, and when the doctor should be consulted if something doesn't seem right.
Good communication forces the doctor to listen for possible hints at why someone isn't taking their medication, and should try to see the problem from the patient's point of view. For instance, if the patient hints that money problems are an issue, perhaps another, cheaper kind of drug can be prescribed.

A trusted relationship with a doctor means that the patient feels included in decisions about their own healthcare, and this means that they will take more responsibility for their treatment.
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