Medication Adherence Resource Toolkit

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As Former U.S. Surgeon General Everett Koop said:

Drugs don’t work in patients who don’t take them

 The following information is provided to assist in your discussions with patients regarding the importance of taking medications as prescribed.  At the bottom of the page you will find links to additional resources, including a link to a PDF version of this material which you can print for use in your practice.


 Up to one-half of all prescriptions may not be taken as prescribed.

For example, many say that they:

  • take less than prescribed
  • take more than prescribed
  • skip doses
  • do not fill prescriptions or refills



Failure to follow directions for prescribed drugs can lead to health problems.


Each year, not taking medications as prescribed causes:
  • approximately 125,000 deaths each year
  • emergency room visits totaling $23 billion
  • hospital admissions totaling $198 billion



Ask yourself the following questions.  If your answer to any of these questions is “Yes”, talk to your healthcare provider.

  • Do you ever forget to take your medicine?
  • Are you careless about when you take your medicine?
  • Do you sometimes stop your medicine when you feel better?
  • Do you sometimes stop taking your medicine if it seems to make you feel worse?
  • Do you sometimes skip doses or skip a medicine entirely because of the cost?


The first step in taking medications as prescribed is to come to an agreement with your prescriber about what medications you should and will take.


For each of your medicines, always ask:


  • What is this medicine for?
  • Does this medicine replace another?
  • How should the medicine be taken?
  • What should I do if I miss a dose?
  • Should it be taken at a certain time of day, with food or on empty stomach?
  • How long will I need to take this? 
  • Will I need a refill before I run out?
  • Are there any possible side effects?
  • What would indicate a dangerous side effect?
  • What would indicate an allergy to the medicine?
  • Should I avoid any other medicine, treatment, supplement, food, or activity while taking this medicine?
  • How long has this medicine been used to treat this condition?
  • Are there other medicines to consider?



Here are some strategies to help take medications as prescribed:


Schedule too complex or confusing 

  • Ask about combination drugs
  • Ask if a simpler schedule is possible
  • Plan reminders, such as timers or calendar aides
  • Take drugs with daily routine such as meals or brushing teeth


 Inability to afford

  • Ask about generic drugs or discount programs
  • Ask about company assistance options
  • Be candid and make sure your healthcare provider knows what you can afford

 Concerns about side-effects

  • Share and discuss your concerns with healthcare provider
  • Ask about tips on how to avoid side-effects


  • Set up pill-boxes by time-of-day
  • Use calendar and check off each dose
  • Set timers or other reminders
  • Schedule doses with regular activities (brushing teeth, meals)



Lack of understanding
  •  Ask prescriber and pharmacist questions
  • Ask for written directions

 Philosophical, cultural or religious concerns

  • Be open and share with prescriber
  • Ask about other options

Be an active partner in your healthcare.  Discuss your medications with your healthcare provider.  The Institute for Nurse Practitioner Excellence (INPE) has more information on taking medicine safely.


 Links to Additional Resources

INPE Medication Adherence Patient Education Sheet

INPE offers a 1.2 contact hour CE program on Medication Adherence, described under online CE tab.

The following are external links, providing excellent resources to enhance medication adherence efforts:

AHRQ Medication Adherence Comparative Effectiveness

American Society on Aging/American Society of Consultant Pharmacists Foundation Adult Meducation Set

National Guideline Clearinghouse--Involving Patients in Decisions About Prescribed Medicines

New York City Medication Adherence Project

World Health Organization Adherence to Long-Term Therapies Report