Patients refusal to take their medication causes

2,5-million emergencies each year

The failure of patients to correctly make use of prescribed medication is becoming a more serious and widespread problem, despite advances in the quality of medication and the creation of awareness and educational campaigns throughout the world. Termed “medication non-compliance”, this phenomenon results in 2,5-million emergencies each year, and is the cause of as many as 125,000 deaths.

According to the National Council on Patient Information and Education in Washington, USA, there is a likelihood of between 30 and 50 per cent that patients will not take prescription drugs as directed by their doctor. At least seven per cent of patients being given a prescription will never fill their prescriptions. 32% of patients fail to purchase refills, as many stop taking medication as soon as they start feeling better. Issues regarding dosage further compound the problem of non-compliance : many patients skip or decrease doses, while others may take doses higher than recommended.. Patient non-compliance affects not only the patient, but the family and society at large : In 1993, it was estimated that reduced productivity, work absenteeism and increased hospital treatment resulting from medication non-compliance costs the United States the equivalent of R600-billion.

The reasons for non-compliance are complex, and include lack of motivation to take medication when no immediate discomfort is felt, as well as absent-mindedness and laziness. Often the resistance has psychological roots – taking medication would force patients to admit to having an illness. In contemporary society, drug therapy is regularly associated with weakness and inadequacy. The philosophical belief of some patients that they alone are in control of their lives exacerbates the problem. Fear is also a major reason for non-compliance, particularly among women – women’s smaller bodies and fluctuating oestrogen levels put them at higher risk than men for side effects from certain drugs. Cost too can deter patients from using medication, with many patients deliberately reducing the drug treatment period in order to save money.

In terms of medical treatment for depression, non-compliance is a particularly dangerous aspect of treatment. On the whole, no therapeutic benefit can be derived from an antidepressant if it is not taken according to prescribed guidelines. Only when the drug is taken consistently are the blood levels adequate to relieve depression.

Although the responsibility for taking medication ultimately rests with the patient, families and doctors can take steps to encourage compliance. Keeping medication in an accessible, visible place can allow for use to be monitored and checked. Doctors in turn have the responsibility of informing and educating patients about their medication. If patients hesitate when handed a prescription, they should be encouraged to ask questions.