Timing Is Everything
Sticking strictly to your medication schedule isn’t just good practice — it’s vital to improve health outcomes for your condition.
"I forgot.” “I did not follow my usual routine.” “I was too late with my dose.” These are the top three reasons why patients, especially seniors — do not take their medications as prescribed or on time.
This information is part of the findings from the Patients’ degree of Adherence, Challenges and preferences towards medicine Taking (PACT) study, conducted between May and November 2022. Involving a sample size of almost 1,300 patients from the Institute of Mental Health (IMH), Khoo Teck Puat Hospital (KTPH), National Healthcare Group Polyclinics (NHGP), National Skin Centre (NSC), Tan Tock Seng Hospital (TTSH), and Yishun Community Hospital (YCH), the study found that 56.4 per cent did not consume their medications as prescribed.
In Singapore, where the ageing population is growing fast, medication-related problems will increasingly become a cause for concern. Failure to consume medications as prescribed can lead to a patient’s inability to manage their medical condition, particularly for chronic illnesses.
As Ms Low Suat Fern, Deputy Head of Pharmacy at Yishun Health, who is also the Principal Clinical Pharmacist at YCH, stresses, “Medication compliance is important to help us manage a patient’s medical condition, be it acute or chronic. As it is a primary determinant of treatment success, it helps to improve health outcomes.”
Feeling The Impact
Primary care practitioners in Singapore face a number of challenges in ensuring patients adhere to their medication regimens. Ms Low points out that doctors often have back-to-back appointments, which may make it tough for them to check with every patient if they are taking their medicine correctly. They also may not always have the chance to ask detailed questions about whether patients are following their medication schedules.
At the same time, if patients do not tell their doctors they are skipping doses, they may get prescribed more medicine than they actually need. “Each medicine dosage is individually tailored, sometimes according to factors like your age and weight, as well as kidney and liver function,” says Ms Low. “Taking too much medicine can cause side effects and problems.” These can lead to an exacerbation of their illness, and in turn, serious health complications.
Lending A Helping Hand
Ms Low suggests that at every consultation, doctors and pharmacists should try to take the time to remind patients how crucial it is to follow their medication instructions and offer tips on how to do it right. They could also give a heads-up about any common side effects and how to handle them. “For those juggling a bunch of different medications, the goal is to make the instructions as clear and straightforward as possible, making it easier for patients to stick to their treatment plan,” she says.
The team at NHG Pharmacy (NHGPh) knows how tricky it can be to keep track of medication, so they recommend handy tools like pill boxes for better organisation, and setting alarms or phone reminders so patients do not miss a dose. “We may also provide patients with a printed medication list to help them stick to their prescribed treatment,” says Ms Low.
The NHG Cares App has a helpful feature that allows doctors to send reminder notifications to patients who may forget to take their medicine. This personal touch aims to keep patients on track with their health routine.
If there is a language barrier, Pharmacy staff ensure patients or their caregivers get advice from a staff member who speaks their language. The medication labels or boxes that are usually in English can also be changed to Chinese, Malay, or Tamil. This ensures that everyone can understand how to use their medicines correctly.
Extending Wider Assistance
With Healthier SG’s focus on general practitioners (GPs) becoming more involved in a patient’s health journey, plans are in place to help patients remember to take their medicines the right way.
Ms Low explains: “If patients are having trouble following their medication schedule because they have too many different kinds to take, their primary physician or pharmacist could review the indication, dose, and frequency of each medication, and consider stopping, reducing the dose and frequency, or simplifying the medication schedule.”
If the cause is due to financial difficulties, patients can seek help from their medical social worker to obtain Medifund assistance. “Subsidies on chronic medications will be extended to patients who are consulting GPs, as a component of the Healthier SG initiative,” says Ms Low.LW
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