Why not Comply part 2

family creating plan

Part II of a two-part series

At first glance, compliance appears to be a patient problem. If patients would just do what they’re told, everything would be fine. The reality is much more complex. In Part I of our two-part series, we examined the psychological barriers to compliance. In Part II, we look at challenges and practical solutions.

External Challenges

Challenge: Not enough time with the doctor.

Physicians’ time is often at a premium. That can work against patient education. Patients who don’t understand their treatment or its rationale have a hard time following directions.

Suggestions: Go to your appointment with written questions.

Find out as much as you can about your condition and write down questions to ask your doctor. Keep a pad where you store your medicine so you’ll have a central place for jotting down questions.

Bring a loved one to take notes.

Record the doctor's orders so you can review them.

Challenge: Too many medications and complicated lifestyle prescriptions to eat better, move more and stress less.

Many stroke survivors take multiple medications. And the more complicated the drug or lifestyle prescription, the less likely a patient will follow it.

Suggestions: Create a medication map — a schedule that covers the whole day.

It plots timing, dose and special instructions, like nutritional support. It organizes all your medication in one place so you see at a glance what, when and how much you should take. A dosing calendar is also helpful because you can check off the date after taking your medicine.

Schedule a “brown bag” session with your doctor or pharmacist.

Put all your prescription and non-prescription medications in a bag and take them to your doctor’s office or pharmacy. They may find overlapping or duplicate prescriptions from different doctors.

Challenge: Lots of doctors.

Patients may have several doctors and get conflicting advice and requirements. They may make uninformed choices or give up.

Suggestion: Appoint a healthcare gatekeeper.

Find a doctor you trust and can ask to be the ultimate arbiter of your treatment. This way you won’t have to make uninformed decisions about conflicting advice or therapies. Ask your pharmacist to review all your medications for problem interactions and then ask your primary care physician to resolve the problem.

Challenge: Cost.

Drugs are expensive. Even patients with good insurance may find that their policy is deficient in prescription coverage.

Suggestions: Comparison shop.

Investigate the prices charged for your prescriptions at several pharmacies. Also check prices at online pharmacies.

Investigate patient assistance programs.

Most drug companies have special programs called patient assistance programs that discount certain drugs. Do a little Internet research and talk to you doctor for advice.

Ask your doctor about cheaper alternatives.

Before you leave your doctor’s office, find out if your prescription is covered by your insurance plan. If it isn’t, they may be able to switch you to a drug that is.

Challenge: Physical limitations

Suggestion: Have medications delivered or picked up for you.

Online ordering essentially brings the pharmacy to your door. (Most brick-and-mortar pharmacies have Internet ordering sites, so you don’t have to start with a new company.) If you can’t get on the Internet, ask a trusted friend or relative to place the order for you or find out if your physician can do it for you.

You may also be able to find a local pharmacy or a mail order pharmacy that takes phone orders and delivers.

Read Part I to learn how psychological challenges can make it tough for stroke survivors to follow doctors' orders.

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