CAN HAVE DEVASTATING CONSEQUENCES
According to the National Council on Patient Information and Education in Washington, there is a 30 to 50% chance that patients will not take prescription drugs as prescribed by their doctors. Furthermore, 7% of patients never fill their prescriptions to begin with. A large number of patients either take their drugs erratically or stop taking them as soon as they get some relief.
Medication non-compliance is viewed as a serious health problem in itself. When patients take their treatment into their own hands and play around with their medication at random, it can have devastating consequences for both the patients and their family members. Psychiatric patients, in particular, should be careful about how they handle their medication. Dr. Kay Redfield Jamison, author of the best-selling autobiography, An Unquiet Mind, learnt this lesson the hard way. Dr. Jamison, a manic depressive, stopped taking her prescribed lithium after only a few months, and was thrown back into a tumultuous roller coaster of highs and lows as a result.
But why do so many patients refuse to comply with their correct medication? The results from a worldwide GAMIAN (Global Alliance of Mental Illness Advocacy Networks) survey, in which the South African Depression and Anxiety Support Group participated, supplies us with a few answers. The survey, which examined the relationship of the patient and health care provider in the diagnosis and treatment of anxiety and depressive disorders, found that an alarming 46.2% of the South African sample had not been educated about the possible side effects of medication. 65.3% of the same sample were not educated about the possible ways these side effects could be diminished. These statistics imply that South African patients remain disturbingly ignorant about the medication they are taking. The study also found that in a third world setting such as South Africa, cost of medication is understandably a big problem for those patients with little or not medical aid.
On a psychological level, certain patients’ refusal to comply with their medication can be seen as a form of denial. For these patients, to take medication would force them to admit having a mental illness and a weakness. They rationalise that they should be able to conquer their problems on their own. Others see medication as the “easy way out”.
Consumers have the right and responsibility to question the medication they are given. Not all medication has been adequately tested and the contra-indications of certain tablets can be dangerous. Women, in particular, are more susceptible to side effects because of them smaller bodies and fluctuating oestrogen levels.
But patients should be discerning in all forms of treatment they consider. Ironically enough, many patients who refuse to consider “chemical” anti-depressants such as Aropax, Cipramil, Luvox, Prozac or Zoloft will happily embrace alternative remedies such as St. Johns Wort (SJW). But natural does not always equal safe. “We still feel insecure about the mechanisms at work with SJW,” says prominent Pretoria Psychiatrist, Dr. Potgieter. “We don’t know the specific receptors in the brain, or the psycho-kinetics involved in the process. We are also unsure as to the possibility of dependence and abuse.”
What is needed is a balance of perspectives and an educational mind. As Kevin Bolon, a Clinical Psychologist specialising in cognitive behavioural therapy, aptly puts it: “Patients must still have a choice (as to whether they take medication or not) but let it be an educational choice.”
Doctors and psychiatrists have the responsibility of informing and educating their patients about why a particular medication is prescribed, how it should be used, what short term and long term side effects are possible, how long the side effects should last for, whether there is a possibility of addiction, how the prescribed medication will interact with other medications and foods, and most importantly, the consequences of not taking prescribed medication at all.
At the end of the day, the consumer is just as responsible as the Health Care Professional is, in ensuring that he/she has adequate knowledge about the medication that has been prescribed. Consumers shouldn’t rule out the use of conventional medication until they have done some extensive research on the matter. They might just find that making a decision to comply with the medication they have been given is the best strategy they could follow.