Healthy Dose of Reality:
Quick Facts on Medication Use

Medicines are powerful therapeutic tools that help prevent and treat illnesses and relieve symptoms.

Most older adults — 4 out of 5 — live with one or more chronic conditions, such as diabetes, high blood pressure, arthritis or cancer. Medicines, along with lifestyle changes (e.g., exercise, diet, smoking cessation), are often needed as part of the management plan for these conditions.
Eight out of 10 adults self-medicate using over-the-counter (OTC) medicines for various health conditions in the past year, most often for colds, coughs and seasonal allergies. In a recent survey, many consumers say they turn to OTCs because of convenience and a desire to save time, money and a trip to the doctor.
And four out of five Americans who visit the doctor leave with a prescription. In 2007, more than 3.5 billion prescriptions were written, and that number is expected to grow to more than 4 billion by 2010.

Unfortunately, many people don’t consult their doctor, nurse or pharmacist, or take the time to learn about how to safely use OTC and prescription medicines. As a result, many Americans aren’t fully informed about their family’s medicines and may be taking too much or mixing medicines inappropriately.

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Surveys find:

Nearly three out of four Americans report not always taking their prescription medicine as directed. They may
  • forget to take the medicine
  • not fill a prescription they were given
  • discontinue the medicine before finishing it
  • take less than the recommended dosage to try to avoid side effects or reduce costs
Half of all American adults—90 million people—have difficulty understanding an acting on health information.
One in five adults who self-medicate admit they have not used OTC medicines as directed, either by taking more than the recommended dose or by taking these medicines more frequently than indicated.

Mistakes happen. Because of the high number of prescriptions, many errors can occur. Studies suggest more than 1.5 million Americans are hurt each year by preventable medicine errors. Medicine-related complications have been  attributed to:

Use of multiple medicines (also called polypharmacy)
Drug interactions
Human error (not filling the right prescription, unclear instructions, giving the wrong dose, forgetfulness)
Poor medical management (incorrect medication prescribed, lack of communication and monitoring)

In addition, patient’s concerns about side effects or how to administer and monitor certain medicines, and other perceptions about the medicine or disease may influence their choices. These include:

Perceptions about the nature and severity of their illness
Denial of illness and the need to take medicines
The assumption that once the symptoms improve or the person “feels better,” he or she can discontinue use of the medicine
Limited appreciation about the value of medicines when properly used
Beliefs about the effectiveness of the treatment
Acceptance of taking medicines for preventive purposes and for symptomless conditions (e.g. statins to lower blood cholesterol levels)
Worries about the social stigma associated with taking medicines
Fear of side effects or concern about becoming drug dependent
Fear of needles and the need for self-injections
Lack of confidence in the ability to follow the medication regimen
Media influence regarding safety or risk issues associated with particular medicines
Lack of positive motivations and incentives to make necessary changes in behavior

Not taking medicines correctly can spell trouble. If people with chronic conditions that require long-term therapy do not take their medicines as prescribed, this can lead to

Unnecessary worsening of the disease
Greater complications from the disease and increased resistance to needed therapies (for example, antibiotic resistance)
Reduced functional abilities
Lower quality of life
Premature death

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Moving Forward: What’s Needed?

Communication is essential. Studies show important gaps in patient-provider communication about medicines, which can contribute to improper medicine use. Talk openly with your healthcare providers, including your community pharmacist, to learn about the medicines you and your family use and help ensure you understand how to take/give them appropriately.

Educate before you medicate. As a spouse, parent or caretaker of other family member, the best way to guard against medicine use problems is to learn about OTC and prescription medicines and encourage your loved ones to be active partners in their healthcare. Always ask questions, seek expert advice from a healthcare provider, and take the time to carefully read and follow the instructions on the medicine label or insert.

Get a “Medication Check Up” at least once a year. Ask your healthcare providers to review all of the patient’s medicines, including supplements and herbal remedies, and determine whether all are needed, if there is the potential for drug interactions or dosage adjustments are needed.

More research is needed. There remains an urgent need for more research to evaluate drug efficacy and side effects in pediatric and older patients. If you or a family member suffers with a chronic medical condition such as cancer, diabetes or heart disease, you may want to find out whether there is a clinical trial that might be beneficial.

For Additional Information: See “Enhancing Prescription Medicine Adhererence: A National Action Plan,” published by the National Council on Patient information and Education at