Most of us attempt to practice healthy habits in a number of ways — we go on walks, take yoga classes, and drink all the trendy healthy beverages. However, very few people eagerly await the time in their day that they take their pills. Some argue that the dilemma of medication adherence should be addressed by shifting a doctor’s focus from the patient to the person. Because, as Dennis Robbins recently said, “Patients don’t change or take ownership or self-determine their futures and destinies. Persons do!”

A shift in focus can mean a myriad of things. To Robbins, this specifically meant freeing a person from being considered and addressed as weak and helpless. Even if a person needs the help of a doctor or is in need of medications, they are still capable individuals. And they are individuals who can execute a plan for health and make use of their meds to become healthier. Not everyone can acknowledge this reality of patients though, and that is where the mindset needs to change.

There is also much more in the works to help people take control of their health. Right now, electronic medication packaging (EMP) is becoming ubiquitous. Some examples of EMP are digital timer caps, pill bottle strips with toggles, standard pill boxes, and calendar packaging — essentially any fancier and more technological version of a pill box. Other types of EMP exist on a larger scale within the healthcare system. Most of these devices integrated into the care delivery system were shown to be effective in improving adherence, which presents EMP as a low-cost way that a person can take initiative after receiving support from their doctor.

One study expanded on the impact of other types of reminders for medication adherence. In addition to calendar blister packaging and calendar pill organizers, participants were sent education about their medication as well as a customized dosing schedule, mailed refill reminders, and received phone calls if they didn’t refill on time. Six out of the 10 trials reported improved adherence, though this cannot necessarily be credited to the calendar features alone. The amount of support that the participants received surely increased their motivation to take their medication and helped them build longer term healthy habits as people — not patients. Although, I assume many of these subjects just groaned at the new mail and admonishing phone calls from unknown numbers and chose to ignore even this extra support.

The kitchen-sink approach was about as effective as individual interventions.  One study combined wireless pill bottles, lottery-based incentives, and social support but this combination did not significantly change the adherence of the patients. Even the elimination of copayments for drugs did not make people significantly more inclined to take their meds. So why not bring more attention to each person and their interactions with their doctor and the medication itself? I believe that this kitchen-sink approach is a good method to improve adherence because it treats someone as a real person and gives them the opportunity to pick their own solution or work collaboratively with their doctor to do so. Collaborative decision making really can make all the difference. No one wants to let go of their role as the decision maker in their own life. We especially don’t want to let a doctor treat us like a sick puppy and not consult us on the next course of action or get new medication that we have no knowledge of. A patient is part of their care and treatment and if you’re in control, you are more likely to adhere.