Take two tablets by mouth twice daily.” This printed instruction, common on prescription pill bottles, might seem
straightforward. Yet in a study, nearly half of patients misunderstood what it or other common label
instructions meant. Now the U.S. Pharmacopeia (USP) the non-profit organization that sets quality and safety
standards for drugs approved by the Food and Drug Administration is aiming to simplify, clarify and standardize
the labels that are affixed to those drugs. A U.S. Pharmacopeia proposal, developed in conjunction with a
group of independent experts, was released early this year for public comment. If adopted by state pharmacy
boards nationwide, its developers hope it will help remove one of the many barriers that discourage people
from taking their prescription drugs.
Medication compliance, or “adherence,” as it’s called, is a big problem. Despite the fact that 87 percent of
people in a recent survey said they thought prescription medicines were important to their health, only about
half of those surveyed take their drugs as directed. People skip doses, take the wrong number of pills, and
take pills at the wrong time of day, among many other problems. Poor adherence results in up to $290 billion
annually in medical expenses each year, according to NEHI, a health research organization.
In general, people are more compliant with drugs for acute conditions such as a bladder infection than for
chronic problems like diabetes. But both are problematic, and the reasons people offer for not taking their
drugs are as varied as the drugs they're not taking. In that patient survey, 59 percent said they stopped
taking their medication because they were feeling better and didn't think it was necessary to continue, while
25 percent said they stopped because they weren't feeling any better. Thirty-seven percent were worried
about side effects, while 24 percent said their drugs were too expensive. With such varied reasons for
noncompliance, experts agree that solutions must be varied, too.
While no single strategy or technology will get everyone to take their medicine as directed, experts agree that
clear instructions on the pill bottle are a basic requirement if that’s to happen. Many of the USP
recommendations seem commonsensical: place patient information and instructions at the top of the label in
bigger type than the doctor or pharmacy name or information on refills and expiration; use everyday words like
high blood pressure instead of hypertension; keep auxiliary information, such as warnings, simple and
(Source: Michelle Andrews; 2/15/11; this column is produced through a collaboration between The Post and
Kaiser Health News. KHN, an editorially independent news service, is a program of the Kaiser Family
Foundation, a nonpartisan health-care-policy organization that is not affiliated with Kaiser Permanente. )
NCPIE encourages healthcare professionals and community groups to foster patient–professional communication about medicines. However, NCPIE does not supervise or endorse the activities of any group or professional. Discussion and action concerning medicines are solely the responsibility of the patient and their healthcare professionals, and not NCPIE.
Please consult a licensed health care professional with questions or concerns about your medication and/or condition.