Remembering to take medication daily may sound like an easy task, but it is important to keep in mind that life isn’t always convenient. Daily medications don’t always have the same time to be taken. One difference in the daily routine could lead to a flow of major adjustments to allow the patient to take the medication properly.
Introduction
For many patients, especially those suffering from chronic illnesses, taking daily medications may eventually become a daunting task. They may feel like they are living their lives around their pill bottles, meaning that going out, planning meals, and maintaining necessary attendance at work may not be simple. While some of the population may not be affected by a change to their routine, a person who must take medications throughout the day likely faces an impact on their ability to take prescribed medication properly.
The potential of this impact could lead to anxiety. For example, a person may fear taking medication around their friends due to the sensitive nature of some drugs. However, even the simplest thought of having to stick to the medication time could lead to anxiety, as many drugs have side effects if not taken as directed. In my time as a retail pharmacy technician, I recall patients asking to speak to the pharmacist to discuss alternatives to taking their medication at events such as a planned vacation. The thought of having to remember medication at a time that should be considered relaxing is difficult. Following, we will discuss the impact of someone feeling like they are living around the pill bottles, such as anxiety, required changes to daily routine, and insurance obstacles and financial burdens.
Living around the Pill Bottle Provokes Anxiety
I must admit, I have almost forgone a dose of my medications due to the fear of highly uncomfortable side effects. Side effects cover a broad range of discomfort, leading to anxiety if a patient feels that they are inevitable. Considering the potential for discomfort, it is understandable when patients may feel like they must plan their day around the side effects of a medication. Some side effects are not only uncomfortable but also could cause embarrassment for the patient. Imagine being at the store when sudden diarrhea or vomiting occurs. The anxiety of possible embarrassment likely leads to patients changing their plans.
Plans for the day may include getting together with friends or family. In addition to possible side effects, the patient also considers that the reason behind their medication or medication itself may not be accepted by the social circle. There remains pressure to “be perfect”. Fear may set in when gathering with others, when a medication is due to be taken.
Patients also have to remember to make doctor’s appointments on time and ensure that their pharmacy has adequate stock of their medication. Many doctors do not write for refills unless the patient goes into the office at certain time intervals. Appointments need to be made well ahead of time to avoid delays in care. Even if the patient meets with the doctor on time, the medication may be out of stock at the pharmacy; therefore, making refill requests on time is vital. Keeping constant track of everything could also lead to anxiety. All the healthcare team members should keep this in mind.
Planning the Day around the Bottle
As mentioned earlier, certain medications may need to be taken at specific times, which can be inconvenient. Many patients choose to stay home during medication times to avoid embarrassment or the need to explain to others.
Numerous factors come into play when taking a medication:
- Some need to be taken on an empty stomach, while others have to be taken with food
- The patient may have to avoid certain foods with some drugs, such as grapefruit
- Certain medications can make a patient drowsy
Due to the numerous factors, many people find it more convenient to change their daily plan altogether to avoid taking their medication or experiencing a side effect, while in public. For example, patients with Hereditary Angioedema, or HAE, report that they sometimes have to miss work or school due to HAE attacks, or because they must call insurance or the doctor to receive their medication. HAE patients also have difficulty with activities such as cooking, cleaning, and chores when they have attacks due to lack of medication. (Arora et al., 2023). When planning the day around medication becomes difficult, nonadherence may occur altogether, in cases such as hypertension (Lane et al., 2022).
Insurance Obstacles and Financial Burdens
Even after patients do everything right in terms of their care, insurance may cause issues at the end. Barriers caused by insurance include:
- Denial to pay for the prescribed medication
- Stating limits to how much of the drug can be filled at a certain time
- Requesting a prior authorization or proof of need from the provider
Patients are expected to pay out-of-pocket if the medication is not covered. While coupons and discounts exist for some drugs, other drugs may be completely unaffordable. I recall in my time as a pharmacy technician helping patients navigate through potential coupons online. Breaking the bad news that the pharmacy staff could not find anything was heartbreaking for everyone involved.
Hereditary angioedema (HAE) and obesity are examples of conditions that require strict therapies but unfortunately encounter barriers. HAE could potentially be fatal; however, medication can improve the quality of life. HAE patients face insurance changes, doctor’s office delays, and insurance denials quite often. Patients report an increase in angioedema attacks resulting from the delays and denials; about half report missing work or school, and many encountered sudden changes to insurance coverage (Arora et al., 2023). Although obesity is the second most preventable cause of death in the United States, treatment is difficult to receive. Factors that contribute to the increase in obesity include reduced access to health care providers, lack of adequate health insurance coverage, and stigmatization of obesity. Insurance commonly covers counseling and surgery in extreme cases, but rarely will cover medication (Miller et al., 2024).
Conclusion
Feeling like life is revolving around pill bottles is overwhelming and anxiety-provoking. Patients may avoid activities altogether to avoid judgment by others and to avoid embarrassing side effects in public. Days may have to be planned around certain drugs. Additionally, even if the patient performs all the necessary tasks to receive the medication, insurance may create new barriers. In isolated cases, this may not seem like a big deal, however, living life around the bottle impacts patients’ lives greatly.
References
Arora, N. S., Nelson, B., Carpenter, L., Wettenstein, R. P., Hashmi, M., Selva, C. N., Castaldo, A. J., & Baptist, A. P. (2023). Consequences of Insurance Coverage Delays and Denials for Patients With Hereditary Angioedema. J Allergy Clin Immunol Pract, 11(8), 2432-2438 e2431. https://doi.org/10.1016/j.jaip.2023.03.006
Lane, D., Lawson, A., Burns, A., Azizi, M., Burnier, M., Jones, D. J. L., Kably, B., Khunti, K., Kreutz, R., Patel, P., Persu, A., Spiering, W., Toennes, S. W., Tomaszewski, M., Williams, B., Gupta, P., Dasgupta, I., Endorsed by the European Society of Hypertension Working Group on Cardiovascular, P., & Adherence. (2022). Nonadherence in Hypertension: How to Develop and Implement Chemical Adherence Testing. Hypertension, 79(1), 12-23. https://doi.org/10.1161/HYPERTENSIONAHA.121.17596
Miller, E., Edelman, S., Campos, C., Anderson, J. E., Parkin, C. G., & Polonsky, W. H. (2024). Inadequate insurance coverage for overweight/obesity management. Am J Manag Care, 30(8), 365-371. https://doi.org/10.37765/ajmc.2024.89587