Although VA does extremely well when it comes to prescribing evidence-based medications for patients hospitalized for heart attacks or heart failure, we do know that a large number of patients are not able to take these medications as prescribed. This is not a problem specific to the VA health care system; it is prevalent throughout the United States. Studies show that 20 to 30 percent of medication prescriptions are never filled by patients, and roughly 50 percent of medications prescribed for chronic disease are not taken by patients the way they are prescribed.
It is intuitive that a prescribed medication will work only when a patient is able to take it the way it was administered in large clinical studies leading to its FDA approval. The dynamics of these large clinical trials, and the patients enrolled in them, differ from what we see in everyday clinical practice. Therefore, both patients and health care providers need to constantly ask what they can do to ensure that maximum benefit is obtained from these medications. With February being American Heart Month, now is a good time to look at what patients can do to improve their chances of taking medications as prescribed. The tips below will apply to other types of medications, as well.
First, it is extremely important to know why you are taking a medication. Understanding the potential benefits of a prescribed medication will increase the chances that you will take it as prescribed. Most of our patients with heart disease are on many medications, which makes it even more important to understand what each medication does with regard to the body in general, and heart health in particular.
Second, it is equally important to know about the risks and possible side effects of any medication you are prescribed. Be proactive and ask your health care provider about this. And if you encounter any side effects from a medication, or you believe some of your symptoms are related to a prescribed medication, bring the issue to your provider’s attention. These days, health care providers have several alternatives that could be used if a patient has a side effect from a particular medication, or a particular class of medications.
Third, let your health care providers know if you are having difficulty refilling your prescriptions. This can be a real problem if you are on multiple medications, with each medication refill falling at a different time of the month. This can be synchronized by your health care team, including pharmacists. Other strategies, like pill boxes and reminders, can also be offered to help you take medications as prescribed.
Last but not least, you will likely need to take most heart medications on a lifelong basis. Therefore, the discussion about these medications (to include their benefits, risks, and side effects) should not be a one-time event. Periodic discussion with your health care provider about why you are taking a medication will not only increase your chances of being able to take a medication as prescribed, but also make you an equal partner in your health care!
About the author: Dr. Salim S. Virani is a staff cardiologist at the Michael E. DeBakey Veterans Affairs Medical Center in Houston, and an investigator with VA’s Center for Innovations in Quality, Effectiveness and Safety. He is also an associate professor at Baylor College of Medicine. His research focuses on improving cardiovascular care, and understanding gaps in the implementation of national cardiovascular guidelines.