I recently discovered an article on Medscape asking “Why Are So Many Patients Noncompliant?” The article details the frustrations of physicians concerning a growing number of patients who do not follow their advice or treatment advice, specifically with prescriptions. The article views noncompliance on the part of patients as one of the most difficult problems with regard to physicians providing “optimal care.”
There were many reasons discussed concerning why patients are not compliant. However, the number one reason was “forgetfulness.” I was quite surprised with this one as I don’t have an issue with forgetting a medication. The reason that concerned me more in the discussion was “not understanding.”
I am a patient with a chronic disease, which resulted in continuous prescriptions. When first diagnosed I was given a paper to read that outlined the side effects and warnings for the drug. Along with that information was a signature line. It was a legal document confirming that I had been made aware of the dangers of the drug and was still willing to take it. If you did not sign the document, you did not get a prescription.
With my second specialist there has been no discussion of the drugs. I have advised when side effects were difficult at which time I received additional prescriptions to combat the nausea and stomach issues.
The article did mention a disconcerting fact that on the average with a new prescription a doctor spends a whopping 49 seconds discussing the drug. I wish that statistic was a little more comforting.
Here’s my experience. I have been taking a medication for four years for rheumatoid disease. Not quite two years ago the doctor lowered the number of pills each week. However, the doctor never changed the dosage with the pharmacy. I advised them it was incorrect, but they said they would not change the prescription unless notified by the doctor. (I do understand that protocol.)
During the next doctor’s appointment I advised the nurse and the doctor that the dosage was incorrect. I thought it was important to have the correct dosage on the script, especially if there were ever an emergency where you had to advise medications and dosages. The doctor seemed completely unconcerned and even told me I would have extras if I needed them. (Huh?!?)
One of the comments made in the article was that once given a prescription the patient is “generally unmonitored by the healthcare system.” I actually find this one rather amusing and insulting – that I need to be ‘monitored’.
My insurance provider has sent brochures to me about the importance of taking medications as directed. I assume this is in response to possible monitoring my records. This takes us back to the correct dosage issue. If the doctor tells me to take less pills a week than is on file at the pharmacy, the rate at which the prescription will be refilled is going to be different than expected – but this makes me look like I can’t take a prescription correctly instead of the correct information not being given to both parties.
My dog spent one year going to an eye specialist. He was great and the medical community could take a lesson from this veterinary specialist. He was thorough and quick in his appointments. You almost had to trip him to ask a question because he was so focused and efficient with time, but he was willing and thorough to respond. Also, when he prescribed medications his assistants would walk you to check-out, give you each prescription, explain what it was for, how to give it and how often and then ask if you had questions. It took less than 5 minutes and the veterinarian did not have to spend (waste) his valuable time explaining this information.
I realize life for a doctor is very different today than in the past — but is it also very different for the patient. Both parties need to find a way to best use the time together and share the information necessary for successful healthcare.
What do you think about compliance? Do you adhere to doctor’s orders and prescription directions? Are directions and medications sufficiently explained to you? Where do you go for advice, if not to the doctor? Do you get everything you want to accomplish done within your appointment time?