Arthritis Today

Skipping Meds?

Many people don’t take their meds as directed. Here’s why – and how to get better at it.


With prescription drugs, “Take as directed” sounds simple. Yet every day, millions of people skip a dose, take it at the wrong time, or use either too much or too little. Any of these can keep your medicine from helping, or even create a health risk. 

Why don’t people take drugs correctly? Express Scripts, which administers large prescription drug programs for various health insurance plans, has been studying medication adherence issues among 850,000 of its members since February 2011. They’ve identified five major obstacles: procrastination involving renewing or refilling, cost issues, forgetting and concerns about the drugs themselves. 

“We were very surprised that forgetfulness and procrastination make up about two-thirds of causes,” says chief science officer Bob Nease, PhD. 

You may not even realize you’re skipping medication. “You can easily recall twisting the lid and taking out a pill,” Nease observes, “but it’s hard to remember the one you didn’t take; you were doing something else instead.”

And when you skip your meds, you miss an opportunity to improve your health – whether that means pain reduction, disease management or lowering your cholesterol. Improve your medication adherence by overcoming common barriers with these six basic solutions from Express Scripts.        

PROBLEM: Forgetting to take medication
SOLUTION: Check out the growing gamut of reminder options like the EZY-DOSE Push Button Series Pill Reminders, which received the Arthritis Foundation’s Ease of Use Commendation. Inexpensive beepers or day-of-the-week pillboxes frequently help. More sophisticated approaches include mobile apps, and bottle caps that flash when it’s time to take a pill. Large pharmacies usually stock several kinds of reminders. Visit for more.    

PROBLEM: Refilling prescriptions
SOLUTION: “About 25 percent of patients are fine about taking medication, but delay getting refills,” says Nease. “Try to get a 90-day rather than 30-day supply. Consider an auto-refill program or home delivery, if available.” It’s a great advantage if someone in your household can point out a dwindling medication supply.  

PROBLEM: Getting renewals
SOLUTION: When you receive a prescription, make an appointment for several weeks before it will end – “even if that’s a year away,” Nease advises. “Doctors can be booked way ahead. Don’t wait until you’ve gotten the last refill. By then, you may run out of meds before getting to see your doctor.” Physicians sometimes phone renewal orders to pharmacies, but don’t plan on this – your doctor may need to examine you before re-prescribing.  

PROBLEM: Coping with costs
SOLUTION: “Cost concerns affect about one in five members,” Nease learned.  “Always check for lower-cost alternatives. Ask your physician or pharmacy if a generic can work, and whether you meet financial requirements for Patient Assistance Programs, generally funded by manufacturers.”

PROBLEM: Overcoming medication anxiety
SOLUTION: Nearly 15 percent of study participants “worry that their drug isn’t working, or is causing an undesirable side effect,” says Nease. “Have an honest discussion with your pharmacist or other health care provider.” Realizing how a medication can specifically help makes it easier to follow directions, and maintain the daily regimen even when you’re feeling healthy.  

PROBLEM: Dealing with self-image concerns
SOLUTION: Express Scripts identified occasional self-image issues, especially in patients who are new to a therapy. Learning that they need a daily medication can rattle their sense of being vital and healthy. “Just take it one day at a time,” Nease urges. “The key is staying on it for two weeks. It’s hard to have your antenna up for that long. Taking this medication every day gradually fades into the background, becoming as automatic as popping a vitamin.”