By Annette R. Karnash, R.N., M.N.
Stories about the cost prohibitive nature of the many medications that older patients commonly take have high-lighted a problem that existed long before the expense of drugs was a hot topic. Many seniors simply do not follow directions when it comes to taking prescription drugs. The more medications they take, the more likely they will develop a compliance problem and the greater the potential danger in not complying. Ten percent of geriatric hospitalizations are due to the non-compliance of medications.
If an older person takes too much of a medication, it is more likely they will exhibit side effects of toxicity; and if they take too little of the medication, the illness gets worse.
A patient may be intentionally non-compliant because of the prohibitive cost of the medication; the side effects that they cause of the lack of symptoms present with some conditions. If a patient feels fine, they may feel they don’t have to take the medication. On the other hand the non-compliance may be unintentional if the patient is confused of doesn’t comprehend. Today’s patients are much more knowledgeable about health care and want to be made aware of options, benefits and risks associated with teach option and want to be involved in the decisions about treatment. Many patients reject the paternalistic model of patient-physician interactions. They want communication two ways.
Angela Hausman, a University of Texas marketing professor found that patient satisfaction correlates with compliance. The happier the patient is with his care, the more likely the compliance.
The errors associated with non-compliance can be identified and eliminated by having patients periodically “brown bag” their prescriptions, over the counter meds, and herbal and vitamin supplements. Directions must be reinforced and there needs to be more contact among them with their physicians, nurses and pharmacists. Patients need to have a sense of control over their treatment plans and this is possible if there is improved communication with the care givers.
