I don’t take my medication like I’m supposed to. I am an incredibly non-compliant patient even though I know it may negatively impact my health. I will use my Flonase for as long as I am symptomatic or those around me are. But, if I stop seeing people with red noses and itchy, watery eyes, I’ll stop taking it until the next round of allergies comes around. I never even took birth control as prescribed. I doubled up on doses and forgot days here and there but never had an unplanned pregnancy — regardless of whatever kind of havoc it may have been inflicting on my hormones. If I had understood the long-term effects of my habits back then I may have been a bit more compliant. But my doctor would see me maybe a total of an hour a year and I wanted to show that I knew my body better.

Right now, medication adherence is one of the leading problems in health care. Only about 50% of patients are taking their medications as prescribed. There are a number of causes that range from social and economic, patient-related, therapy-related, and condition-related factors, as well as larger problems within the healthcare system. All of these factors have led to increased chances of morbidity and death among patients and have cost the U.S. healthcare system between $1 billion and $289 billion annually.

The way people are taking medication and approaching their health is scary, but not all that surprising. Sticking to things, especially a new daily habit, is hard and if there are a lot of reasons pushing against you, most people would just stop taking their medication in a responsible and timely manner. About 12% of patients never fill their prescriptions. And another 12% won’t take the medication after picking it up from the pharmacy. Many patients do tests of their own and stop taking their medications to determine any difference in how they feel. But with ‘silent’ conditions, such as heart disease and high blood pressure, the patient won’t feel a significant difference when on or off the drug and do themselves more harm by stopping than they realize. This is especially true when they don’t receive adequate information from their doctor about the drug and how it is working for their specific condition.

Medication reminds people that they are sick and no one wants to consider themselves sick with anything. But the reality is that they need that help because eventually, they are going to die. No one likes to think about frailty. We don’t want to be reliant on doctors or medicine to keep us going. And we especially don’t want to bank on people who are educated in a confusing and scary subject. But we do need to face these truths at some point because hospitals really are big and scary black holes where people die and die badly and we just don’t want any part of it.

So when a study finds that 62% of patients forgot to take their medication, 37% had run out of the medication, and 23% were just careless about taking it, it seems to me that none of this is really just forgetfulness or carelessness. There are underlying feelings behind not adhering to your medication. Maybe it’s a distrust of doctors or of medicine, a rebellion toward someone foreign telling you how to care for yourself, or just that deep fear of death popping up. Whatever it is, better communication can probably help ameliorate that.

While doctors simply do not have time to help us as personally as we may like, they can give us something more personal that can help educate about our medication, our condition, or what exactly the small white (or red or green or blue) pill is doing. If a patient knows more about their disease state and exactly how their medication can and will help them they are more likely to have the motivation to take it. This motivation can make all the difference in their adherence and in the improvement of their condition. The knowledge of the pharmacist and/or the doctor can also make a big difference for the patient. We all feel much more comfortable with our disease or illness when the professional giving us a solution does so with confidence.