Medication-taking made easier

Six decades ago, a crooning Mary ­Poppins told us it takes just a spoonful of sugar to help the medicine go down. But reality is a bit more nuanced: a sour taste isn't the only thing that can turn us off from taking medication — and there's far more than one strategy to make the task easier.

About half the time, people on their own choose to alter how much, how often, or how long they take a medication—or whether to take it at all. In fact, 20% to 30% of new prescriptions are never filled, according to the CDC.

Such medication nonadherence (as it's called) can gravely threaten your health, says Dr. Suzanne Salamon, clinical chief of gerontology at Harvard-affiliated Beth Israel Deaconess Medical Center. It's linked to about 125,000 deaths in the United States every year, according to the CDC.

"A huge number of people don't take their medications as directed," Dr. Salamon says. "It's no joke, and unfortunately it can very easily happen without anyone noticing. Most people don't want to admit to anyone they're not taking their pills."

Reasons for nonadherence

About three-quarters of Americans ages 50 to 64 take prescription drugs, a proportion that climbs to nine in 10 people ages 65 and older. This translates into many occasions and reasons to do it wrong. Dr. Salamon highlights common explanations patients offer for not taking their medications:

Too many. It can seem overwhelming if you've been prescribed multiple drugs, especially if you need to take each one at various intervals during the day. "Sometimes the burden of pills gets so high that people stop taking everything," she says.

Burdensome side effects. From leg cramps to nausea to weight gain and more, there's a huge range of unwelcome offshoots from prescription drug regimens. "Every medication we take has some sort of side effect, and some people are really sensitive to them," she says.

Lack of symptoms. If you feel well over all, you may not think a prescription is necessary. "If someone hasn't explained why they need to take the medication, many people won't do it," Dr. Salamon says.

Expense. Some people can't afford to fill prescriptions or are forced to take less to make their supply last longer. "Cost is a huge factor," she says.

Forgetfulness. This can happen to anyone, but it's more common among people with memory problems. "If there's no family member watching closely or patients haven't spoken to their clinician, it can be hard to find out they're forgetting to take their pills," she says.

Depression. "When people get depressed, sometimes they throw their hands up and say, 'What's the point?' It's very important to address this feeling of hopelessness," Dr. Salamon says.

Easing the task

It's crucial to let your doctor know if you're not taking your prescription drugs — and why. Start by asking her to review your medication list, since "deprescribing" drugs can be just as important to your health as starting a new, necessary prescription.

"Some people were put on medications years ago and don't need them anymore," Dr. Salamon says. "Discuss with your doctor which medications you could really live without."

Also try these additional ways to keep up more easily with your medication regimen:

Find flexibility. Doctors can often streamline dosing schedules by reducing the number of times per day a drug is taken or prescribing long-acting or combination versions. "Moving all medications to once-a-day dosing isn't necessarily ideal, but it's often possible," she says.

Investigate less-expensive options. "Your clinician may be able to find a cheaper alternative," she says.

Use a pill container. An organizer lets you dole out doses for a week at a time. Then, each emptied compartment confirms that you remembered to take your pills. Readily available in stores and online, some pill containers include sections for multiple doses at various times of the day.

Track doses with tech. Replace standard drug bottle caps with timer caps. Found in pharmacies and online, these incorporate built-in timers that track when you last took your medication and alert you when the next dose is due.

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