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Common Problem: Skipping Doses

Tuesday, February 8, 2005; Page HE05

Former U.S surgeon general C. Everett Koop put it simply: "Drugs don't work if people don't take them."

He was addressing a major problem in medicine today: failure to take prescribed drugs. Discomfort with the delivery method -- say, fear of needles or dislike of pills -- is one contributing factor. To understand why so much interest exists in new ways to take drugs, it helps to appreciate the scope and cost of the noncompliance problem.

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Roughly half of all medications prescribed for patients with chronic conditions are not taken, according to some studies. Between 14 and 21 percent of patients never fill their prescriptions, reports the National Council for Patient Information and Education. For people with particular conditions, the problem is worse: Some 40 percent of people with hypertension don't follow their drug regimens, according to a report in the journal American Heart; for those with diabetes, the figure is between 40 percent and 50 percent, according to the journal Diabetes Education.

In at least some cases, experts say, the consequences are sickness and higher health costs. Noncompliance is the cause of 10 percent of hospital admissions, according to the National Pharmaceutical Council; the problem results in more than 125,000 deaths in the United States each year, the group says. The price tag? More than $100 billion a year in "additional health care and in lost productivity" nationwide, estimates the American Medical Association.

In addition to new drug delivery methods, other potential solutions being explored include: automatic electronic reports from pharmacists to doctors on which prescriptions are being filled; new alarms and paging systems to signal patients that it's time to take their medications; and new drug packaging (for example, electronic bottle caps) to help monitor correct drug dosage and timing.

For more information: The National Council for Patient Information and Education, a coalition of more than 130 medical and advocacy groups, offers extensive information on its site about medication, side effects and drug safety issues. (www.talkaboutrx.org)/

-- Ranit Mishori

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