According to the Centers for Disease Control and Prevention (CDC), six in 10 adults in the United States have been diagnosed with a chronic disease and four in 10 adults have two or more. Diabetes, heart disease, high blood pressure (also known as hypertension), chronic obstructive pulmonary disease (COPD), arthritis, and cancer are just some of the conditions that are considered chronic because they last one year or more and require ongoing medical attention and/or limit activities of daily living.
Not only are chronic diseases the leading cause of death and disability in America, but they are also a leading driver of health care costs, accounting for almost 75% of the $4.1 trillion we spend as a nation on health care each year. In addition, people who have a chronic illness are at a higher risk of severe illness from COVID-19, flu, pneumonia and other viruses.
The good news is there are several ways people can manage chronic conditions and avoid further complications. This includes making healthy lifestyle choices, such as:
- Being physically active every day
- Eating a healthy diet
- Avoiding tobacco use
- Limiting alcohol use
- Getting vaccinated for COVID-19, flu and pneumonia
When it comes to treating chronic illness, surgery, physical therapy, psychological therapy and radiotherapy may be helpful. However, the most common treatment form is the use of medication. The majority of adults who have chronic conditions use prescription drugs. For example, 98 percent of people with diabetes and 89 percent of people with arthritis have been prescribed medications as part of their treatment plan.
“In order to prevent illness, progression and death, adherence to prescribed medications is critical for patients with chronic disease conditions,” said Cindy Will, a Clinical Pharmacist with Independent Health. “If you have a chronic illness, you probably have multiple medications to take to help treat your condition. Unfortunately, dealing with medicines can be one of the harder parts of your care because you have to track them, know how to take them, and perhaps deal with side effects. This can be difficult for some people and, thus, have a negative impact on their adherence to long-term therapy.”
Adherence is a big problem
According to the World Health Organization (WHO), only about half of all chronic disease patients take their medications as prescribed by their doctor. Poor adherence is considered a major drug-related problem and is associated with increased emergency-room visits, hospitalizations, and suboptimal clinical outcomes, all of which are associated with an increased burden on the health care system.
“There are a number of reasons why we see poor medication adherence in patients with chronic conditions,” said Will. “For many people, the number of medications they have to take and the frequency in which they have to take them can be overwhelming. The out-of-pocket costs associated with medications can also present them with some challenges, too. As a result, they stop taking the medications and their condition worsens.”
When a chronic disease is not properly managed, it can affect what someone can and cannot do on a daily basis. People with COPD, for instance, who do not use their inhalers as prescribed may stop attending family functions shopping for themselves because they simply cannot breathe.
“On the other hand, we cannot feel high blood pressure when it worsens,” adds Will. “As a result, we may only realize the consequences of not taking our medications when something bad happens, such as a heart attack or stroke.”
Do your due diligence
For individuals living with a chronic condition, Will says it’s important to be an active member in their health care and to use reliable sources like their doctors and pharmacist to get the facts. When prescribed a new medication, she suggests asking a series of questions:
- What is this medicine for?
- How quickly does it work?
- Will I feel it working?
- What are the common side effects?
- What do I do if I experience a side effect?
“Always make sure you understand what the directions mean. What is an empty stomach? What exactly is threetimes daily? What does ‘as needed’ mean,” Will said. “Also, you’ll want to ensure the medication fits your lifestyle. If it’s an injectable medication, you’ll want to know that it’s right for you. Or if you have financial constraints, ask if there is a generic alternative for the medication. Most generic drugs are just as effective as brand-named medications but cost less.”
Taking medications properly
Once you start taking a medication to treat your chronic condition, never adjust the dose of a medication or the frequency that you take it without speaking with the doctor that prescribed it. Medications are prescribed at a particular dose because that is the dose that gives the intended result. Therefore, always follow the directions on the label.
“If you are prescribed 50 mg once a day, then take it as prescribed. No more or no less” said Will. “If you only take one half of the prescribed dose, you may only see half of the intended result or no therapeutic effect at all. And if you exceed the number of times you’re supposed to take it, you could get side effects that could potentially be dangerous and land you in the hospital.”
Another common issue is that many people simply forget about their medication or can’t remember if they took it or not. To avoid this issue, make taking your medications part of your daily habit. Try to associate taking medications with something you already do every day, such as taking your morning medications when you brush your teeth or before having your first cup of coffee
“You can also leave your medications out where you can see them, hang notes if you need to, or use a pill box,” said Will. “Some pharmacies can even put all your medications together in one package so that they’re organized by dose, days of the week and time of day that the patient takes them.”
The bottom line, according to Will, if you want to live the best life you can with a chronic illness, you must be adherent to your drug regimen. After all, as former U.S. Surgeon General Dr. C. Everett Koop once said: “Drugs don’t work in people who don’t take them.”