How to tell if you are following your treatment properly
Simple questions and checks to find out whether you take your medication as agreed with your doctor, and what to do if you find you are slipping.
In short
- Following your treatment properly means taking each medicine at the dose, time and in the way agreed with your doctor, and for as long as agreed.
- Four simple questions, based on the Morisky-Green test used in Spanish primary care, give you a first idea of how you are doing.
- Counting the tablets you have left and comparing your pharmacy collections with what you should have used is a more objective clue than memory.
- If you find you are slipping, do not blame yourself: identify the reason and talk to your doctor or pharmacist, because it can almost always be solved.
To know whether you are following your treatment properly, combine two things: ask yourself a few honest questions about how you take your medication, and check with evidence, such as the tablets you have left over or the boxes you collect. Memory is unreliable: it is easy to think you never miss a dose when in fact you miss one every week.
Doing this review every now and then is not about distrusting yourself; it is a way of making sure your treatment works as it should.
| What will you find in this article? |
What does following your treatment properly mean?
It means that what you do matches what you agreed with your healthcare professional: the right medicine, at the right dose, at the right time, in the right way (for example, with or without food) and for the whole planned period. In healthcare this is called treatment adherence.
In its 2003 report, the World Health Organization (WHO) warned that poor adherence appears in every condition where people take their own treatment, and that in developed countries adherence to long term treatments averaged 50%. It is not a problem for just a few people: it can happen to anyone.
- Taking: not skipping doses or taking extra.
- On time: keeping to the times and the gap between doses.
- Correctly: following instructions about food, position or how to take it.
- Persisting: not giving up treatment too early, even when you feel well.
Which questions help you find out?
A good starting point is the four questions of the Morisky-Green test, a questionnaire developed to assess adherence in high blood pressure and validated in Spain. According to the review by Rodríguez Chamorro and colleagues (2008), a person is considered adherent if they answer all four correctly.
| Question | Answer that indicates good adherence |
|---|---|
| Do you ever forget to take the medicines for your condition? | No |
| Do you take your medicines at the prescribed times? | Yes |
| When you feel well, do you stop taking your medication? | No |
| If it ever disagrees with you, do you stop taking it? | No |
This test is not a diagnosis but a way of stopping to think. Its advantage, according to the same review, is that it gives clues about the causes of non adherence. The review also notes that, in these questionnaires, many people say they take all their medication when they do not, so it is worth backing it up with more objective information.
If one of your answers is not the "right" one, that is fine: you have just found where you can improve.
What other clues can you check?
The most reliable clues are the ones that do not depend on memory: how many tablets you have left, when you collect each medicine and what your alarms or pill organiser record. Checking them once a month takes a few minutes.
| Clue | How to check it | What it may show |
|---|---|---|
| Leftover tablets | Count what is left and compare it with what you should have taken since you opened the box | If many are left, doses have been missed |
| Pharmacy collections | Compare when you collect each box with how many days it should last | If you collect less than you would use, something is off |
| Pill organiser or medication prepared by dose time | At the end of the week, check which compartments are still full | Which dose you miss most: morning, evening... |
| Alarms or apps | Look at the history of confirmed doses | Days or times when you slip |
| Your check ups | Blood pressure, glucose or other readings | If they do not improve, mention it, although the cause may be something else |
MedlinePlus advises not relying on memory alone and reading the labels every time. If the doses you miss most are the ones not linked to any routine, it will help to link each dose to a daily habit.
What should you do if you find you are slipping?
First, do not try to make up for it: never take double doses to catch up on missed ones. Second, look for the cause, because the solution depends on it, and discuss it with your doctor or pharmacist.
| Common cause | What can help |
|---|---|
| Forgetting | Alarms, linking the dose to a habit, medication prepared by dose time |
| Times that do not fit your life | Asking whether the time can be changed or the schedule simplified |
| Side effects | Telling your doctor: there may be alternatives |
| Doubts about whether you need it | Asking for an explanation of what it is for and what happens if you do not take it |
| Too many medicines | Asking for a review of your whole treatment |
If you have already missed a dose, follow what the leaflet says, as we explain in what to do if you miss a dose.
A practical example: Marta does the maths
Let us take the example of Marta, 58, an office administrator with high blood pressure and high cholesterol. She takes a blood pressure tablet in the morning and a cholesterol tablet at night. If asked, she would say she never forgets.
One day she decides to check. She opened both boxes of 28 tablets on the same day, 24 days ago:
- She has 4 of the morning tablets left: exactly what she expected.
- She has 9 of the evening tablets left: she has missed 5 doses in less than a month.
Thinking about it, she realises she slips on days when she eats out or goes to bed late. She mentions it to her pharmacist, who suggests keeping the box next to her toothbrush and setting an alarm, and advises her to ask her doctor whether she could take it at another time. The following month, the count comes out almost perfect.
How can IMA Health help you?
With your medication prepared by day and time, knowing whether you have kept up is as simple as checking whether any dose is still unopened. At IMA Health we coordinate with a specialised pharmacy that prepares your medication this way, we deliver it to your home and we provide personalised follow-up. You can see how it works in the IMA Health service.
Sources
- WHO: Failure to take prescribed medicine for chronic diseases is a massive, world wide problem (2003)
- Rodríguez Chamorro MA et al. Review of tests used in clinical practice to measure treatment adherence. Atención Primaria, 2008 (in Spanish)
- MedlinePlus: Medication errors (in Spanish)
This article is for information only and does not replace advice from your doctor or pharmacist.