Practical ideas for improving adherence and essential questions to ask the healthcare team.
With the growing complexities of taking oral anticancer therapies—multiple medications, complicated dosing schedules and various side effects—it can be challenging to remember to take a pill on time, much less the correct manner in which to do so. There are many different methods available for keeping track of oral medications, but finding what works best for an individual patient is most important.
The Health Belief Model, which was developed by public health experts, essentially helps patients weigh the risks and benefits of a health decision, in this case, taking an oral anticancer medication. With this model, patients have to believe a few simple concepts in order to take action (and to take their medicine): they have to believe that the illness is serious and they are vulnerable to it, realize that taking action will help, feel they can follow through, understand the barriers to completing the task and have strategies for completing the action. For example, a full compartment in a pillbox can be a reminder to take the medicine, while an empty one is reassurance they’ve followed through.
Another technique is called compliance therapy and comes from the field of psychiatry to help patients continue with their anti-psychotic medication. The basis of this technique is self-reflection, with the idea being that critical thinking can help improve an individual’s motivation. Patients are asked open-ended questions to help them better articulate for themselves why and how they should keep up with their medicines.
When first handed a prescription, patients need to make sure they understand what it says and what it means going forward. If they don’t understand, they should feel free to ask their doctor or nurse questions (see list). They should also find out who they should be in contact with if they have questions once they start taking the drug. Some doctors’ offices might have a system in place for automatic reminders, or may provide telephone support or can have other tools, education materials and tips to offer.
There are plenty of apps for smartphones and other devices that can be used as alarms or reminders. In June 2007, the Food and Drug Administration approved the Electronic Medication Management Assistant (EMMA), which stores and dispenses medication and lets doctors monitor their patients’ day-to-day well-being, including allowing doctors to adjust doses and medication times.
Support groups can sometimes provide the best advice—from someone who’s been there. These groups can be a source of practical tips on taking pills and managing side effects, as well as providing recommendations for resources that might be able to help with other issues, such as treatment costs. Patients can also enlist the help of family and friends who can help out with reminder phone calls or by learning about the prescription.
Research has shown that a crucial component in taking medications correctly and on time is communicating with the healthcare team. Here are some questions patients and caregivers can ask the healthcare team when a new prescription is issued:
> What is the name of the medication (both trade and generic)?
> Who prescribed the medication?
> What condition is it supposed to treat?
> What is the dosage of the medication?
> How often it is it taken?
> What time it is it taken?
> What are the side effects?
> Who should be called if there are side effects?
> What foods or drugs could interact with this medication?
> What if a dose is missed?
> When will this prescription need to be refilled?
> How does this drug need to be stored?