If Patients Only Knew


by Dorothy L. Smith, Pharm.D.

Patients would think twice if they only knew how dangerous it is to:

  • Stop a prescription drug prematurely
  • Stop a medication without telling their physician
  • Take half a dose in order to save money

Patients need to know that the cost of the medication is minuscule compared to the costs of treating the complications of patient nonadherence.

I have been writing on this subject for 30 years and am running out of filing cabinet space! Once health professionals, manufacturers and insurance companies realize that the patient “holds the power”, they will understand why so many treatment outcomes are not successful and why overall health care costs keep skyrocketing. We need to recognize that the patient has to make decisions every day on how to manage their medications. For example, more than 95% of diabetes care is done by the patient. This is why adherence and patient decisionmaking are so important in the treatment of diabetes.

I believe that patients are making decisions to the best of their abilities and are trying to do the “right thing”. When they make a mistake, it is usually not their fault…they just didn’t receive the type of information they needed in order to make a wise decision at that particular moment.

One of the most effective methods of motivating patients to stay in treatment is to teach them how to recognize that their medication is “working”. Once patients are able to recognize their personal progress, they are more willing to stay in therapy.

Health professionals also have to change their approach and recognize patients as being experts for their own lives. This will require that they individualize the therapy and help patients create a treatment plan that works for both the patient and the health professionals.