Thursday, May 22, 2008

A Case of Medication Non-adherence

Is this an acceptable case of medication non-adherence or just my own lack of planning?  Of course there is no acceptable reason for medication adherence - if you want to get better, you take your medications.  Plain and simple.  

I lived through the agonizing pain of flushing with 1000 mg of Niaspan, including the spaciness, and insomnia due to the nightmares of my flesh burning.  The cost of switching to a HSA with three medications for me, two for my wife and two for my son - luckily back to a regular payor.  And created Intelecare reminders to help me remember to take my medications (one trick I like is to keep some meds at work, just in case).

So here is my case:  My wife went into labor with our second son two weeks early, at 2 am on a Saturday night.  She woke me at 4 am and told me that we had to leave for the hospital immediately.  I quickly packed a toilet kit for us both (including my meds but not hers) and some clothes, then went to the hospital; she gave birth at 5:45 am.  Our medication schedules were not top of mind.  Luckily for her, the nurses knew she was on medication, and the attending physician prescribed her a two day supply.

Once we settled into our room at 8 am or so, I did not unpack our bags.  We napped until 1:30 pm and then started accepting visitors.  I went home at 9 pm or so with our 1st son,  and realized I left all my meds at the hospital.  Thus, I ended the day non-adherent to my two morning, and two nighttime medications.  

The next day was a rush of our nanny starting, buying items for the baby (car seat, diapers, new bottles, etc...), and fielding calls.  I made it to the hospital around 1:30 for lunch, but the bag I packed for Courtenay still was not open.  I had more errands to run, then returned around 7 for dinner.  I finally got my medications, and took that nights does when I went to bed.

The next morning (Tuesday), I only had two more Tricor, so I called in a refill, but was unable to pick it up until yesterday (8 days late).  Luckily I had my extra stash in my office.

Now these medications I take are for asymptomatic conditions - high cholesterol, and high triglycerides - but what if they were for asthma, diabetes, or high blood pressure and I suffered an attack?  

Life sometimes gets in the way of staying adherent to your medication schedule.  I usually operate at 100% adherent to my daily schedule - whether the morning disbursement is at 7:30 am when I brush my teeth or 9 am when I get into the office.  My test results were too positive not to continue taking my meds.  These drugs lowered all of my levels, and put me in a safe zone - although I still need to go down a few points, and now my sugar levels are higher which is characteristic of one of my meds.

I gave myself a pass for Monday and Tuesday of last week.  But my overall adherence for the month dropped significantly.  Maybe I should keep an extra supply in my car as well?

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