Can we improve how well people take their medicine?

In our modern health care system, prescribing medicines is one of the main ways that doctors treat illness and prevent more serious diseases.

But the evidence clearly shows that many people do not take their medicines as prescribed. Between 20 and 30 percent of prescriptions are never filled. And for those who do fill their prescriptions, approximately 50 percent do not take them as directed.

Doctors and pharmacists have long understood this problem, and researchers have developed a wide range of programs to help encourage people to take their medicines. But an updated systematic review from the Cochrane Collaboration found ample room for improvement in this area.

The review includes a total of 182 studies, including 17 randomized-controlled trials.  On the whole, the reviewers found the interventions were complex and used different methods for encouraging people to take their medicines as prescribed. Often times, family members, peers, or health professionals such as pharmacists, were involved in encouraging the patient to take their medicine.

Of the 17 randomized-controlled trials, only five identified intervention programs that improved participants’ medicine adherence and health. And the reviewers could not identify any common characteristics in these studies that lead them to be successful.  The reviewers concluded, “Overall, even the most effective interventions did not lead to large improvements.”

At the end of their review, the researchers call for better interventions, better ways of measuring adherence, and new research with enough participants to offer some meaningful evidence about the best ways to solve this problem.

The take-home message?  Sometimes, the evidence shows us that we don’t know enough about a topic.  In this case, there is a clear need for more research about ways to encourage people to take their prescribed medicines.