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Introduction

Research indicates nearly 50% patients fail to take their medications as instructed by a health professional. Known as medical non-adherence, this practice can be extremely dangerous in many instances, leading to prolonged or more severe illness, and, in some instances, even death. In fact, the Centers for Disease Control and Prevention (CDC) estimates 30-50% chronic disease treatment failures and 125,000 deaths in the US alone are linked to non-adherence! Needless to say, this is rather concerning.

Often, non-adherence to one's medicine regimen is the result of mere carelessness or forgetfulness. According to the World Health Organization (WHO), however, the primary root causes of non-adherence can be linked to one of the following five reasons -

Root cause of non-adherence

1) Health System Issues

Sometimes patients lack access to quality healthcare, or they are unable to receive continuity in healthcare. Other times, patients suffer from a poor relationship with their healthcare provider, which lacks clear communication - for example, the patient might not even be aware of the names of each medicine or the reason behind being prescribed each of them. Not having all the necessary information on hand can result in poor decision-making.

2) Medical Condition

If a patient has an asymptomatic chronic disease, there might not be any physical cues for them to know they are actually still ill and need to see their treatment through to completion. Such a patient may mistakenly conclude that lack of symptoms means they are okay. Likewise, patients suffering from mental health disorders, including depression, might not be able to pinpoint what's happening in their mind/body and hence terminate treatment abruptly, without approval from a certified medical practitioner. In both of these scenarios, patients are basically unaware of the consequences of suspending treatment mid-way and lack full understanding of their own illness(es).

3) Patient-Related Issues

Patients who face physical, cognitive, psychological or behavioral impairments might not be able to follow-through on medical adherence, even if they wish to. Lack of support is a huge hindrance in medical adherence. In addition, people who are young (i.e. minors) might not even have control over medication adherence if they are dependent on a parent/guardian who isn't sound in their own decision-making capabilities.

4) Complicated Therapy

If a patient's treatment is extremely complex, it might be difficult for them to comply fully. Or, if treatment entails side-effects, a patient might terminate medication mid-way out of fear, unaware of the long-term consequences of not putting up with short-term side-effects. Again, this can also be linked to Issue #1 - a poor relationship with one's healthcare provider.

5) Socioeconomic Barriers

Lastly, according to the World Health Organization, the fifth reason for not being able to adhere to one's medicine regimen can be linked to barriers that are socioeconomic in nature, such as illiteracy, inadequate social support or inability to afford high medication costs. For example, many diabetes patients in the United States try to stretch out their medication for a longer period of time to lower costs if they don't have health insurance - this has been proven fatal in many cases.

Ways to improve adherence

So, how does one address these five central issues that come in the way of medicine adherence? Here are four smart tips from the U.S. Food & Drug Administration (FDA) -

1) Communicate

Maintain clear communication with your doctor or pharmacist about side-effects, adjusting dose timings, information surrounding how long you really need to take medication and severity of consequences for earlier termination, as well as any financial issues surrounding paying for prescription drugs and possible solutions, such as generic medication. Never be shy! Having enough information and support will enable you to stay motivated to adhere to a particular regimen, without any hassle.

2) Simplify

Rid yourself of confusion and difficulties in keeping up with medication schedules by setting a medicine routine linked to daily activities (i.e. going to bed, brushing your teeth, meal-time). It is also a good idea to store medicine where it is most noticeable (i.e. on the dining table, next to your deodorant, etc.). Experts often recommend simplification of medicine schedules to help boost greater adherence. Try asking your doctor if they can prescribe a once-a-day or twice-a-day alternative dose to make it easier to set a pattern you can remember and stick to.

3) Reminders

Try out different tactics to remind yourself of medicine-time, such as written/computerized medicine schedule calendars, automatic pill dispensers, mobile notifications, or even daily dosing pill containers that are properly labelled. If you opt for pill containers, try to set a routine for refills each week on the same day, same time, also linked with a routine activity (i.e. Sunday morning post-breakfast). Pro Tip - If you decide to buy a pill box, get a timer cap so it goes off each time you need to take the next dose - it aids in combating forgetfulness. Or, you can even set two reminders - a timer cap and a mobile notification!

4) Preparation

Keep backups of your medication in different locations (i.e. your purse/briefcase/car/workplace) so you can prepare for any situation, such as changes in your schedule that don't allow you to be at a standard location during medicine-time. If you're travelling, keep extra doses in case your flight is delayed or you decide to suddenly extend your stay. Better safe than sorry!

Conclusion

For some patients, a reminder system that involves friends/family does the trick. For others, the tools mentioned in Tip #3 work wonders. However, we at Kaleido have tried to develop a more holistic solution in the form of our Kaleido Box Subscription Pharmacy Service. A 2009-based research study indicated 76% people adhere to medicine regimens when it is convenient. Similarly, a research study, which examined the effect of a pharmacy care program on medication adherence, indicated an improvement from 61.2% to 96%. Our team has put convenience at the forefront of our adherence tool after carefully taking patient needs into account so they can reach their optimal health. Here's how it works -

1) Send us a photo of your prescription (you can also do this on behalf of a loved one you want to help out).

2) We pre-sort and organize these medicines into packets that are simple to open. These packets are clearly labeled with names, times and dates of meds.

3) We insert all of these pre-sorted and clearly labeled medicine packets into one box for centralized access.

4) Your Kaleido Box is delivered to your house for maximum convenience - no need to wait in line at the pharmacy!

5) We monitor your refills so there are no gaps in your medication cycle.

Added Bonus - We can customize your boxes as and when your treatment changes, and can also include vitamins and supplements.

Want to sign yourself or a loved one up for the Kaleido Box service? We're offering a 1-month free trial so you can experience the above mentioned seven benefits first-hand by using the coupon code 'TRYBOX'. Click 'Login' to get started.

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