Medication Adherence

Practical tips

Long-term adherence often requires more commitment and organization than patients are prepared to take on. However, several practical tips and tricks can help you adhere to your anti-cancer medications.

Not every suggestion will make sense for every person, so look for ideas and methods that fit easily into your lifestyle. Try to include one or a combination of the following tips to help keep you on track.

Educate before you medicate

Learning about your drug is one of the most effective ways to improve adherence. Once you know how to take your drug correctly and safely, ask follow-up questions about anything you don’t understand before you begin treatment. See page 8 for a list of questions to ask your medical team or pharmacist to help you become more familiar with your medication.

Make a pledge and commit

The simple act of writing a pledge to adhere to your anti-cancer medication can help reinforce your commitment to taking your medication correctly. Clearly state why it’s important for you to adhere to your medication: “I will take my [drug name] today to help me fight my cancer.” Refer to your pledge daily or as needed for a constant reminder of the significance of taking your medications.

Keep track of your meds

Complicated drug names, difficult schedules and the realities of everyday life make adherence difficult. Don’t try to remember everything! Instead, make a list of all medications and medicines – prescription and over-the-counter – to help keep you and your treatment team organized. Be sure to include the name and contact information of the doctor who prescribed each drug in case you have any questions. Provide a copy of this list to everyone on your health care team so they can help you manage your medications and avoid drug interactions. Keep a copy at home, give one to a family member or caregiver, and keep another copy with you, especially when you travel. Make sure to update all copies if your treatment changes, and redistribute them accordingly.

Create a calendar or schedule

Patients can benefit from creating a calendar that helps them adhere to their anti-cancer medication, especially if their treatment regimen is complicated. Include the exact days and times you’re supposed to take your medication, and keep your calendar in a visible location. The easier it is to read and follow, the better. You can also take notes to help keep track of your side effects or to record important dosing information (missed or skipped doses) so that you can keep your doctor informed when necessary.

Set up reminders

Forgetfulness is one of the most common causes of non-adherence, which is why setting reminders can be the best way for many patients to adhere to their treatment plan. Take your medication at the same time as something that’s already part of your daily routine, such as brushing your teeth or going to bed. This can help you take your meds at the same time every day and establish a routine that's easy to follow. Set an alarm to keep yourself on track, or try another helpful tool, such as a pocket pill box that vibrates, a watch with reminder alerts or a voice alarm. There are also many apps that can help you manage your medication with your smartphone or tablet (see box below). Many of these apps are multifunctional, allowing you to create alarms for multiple medications, research drug interactions, keep track of refills and more.

Organize your pills

Weekly pill organizers are an effective way to keep track of your medications. Organizers come in different sizes and are especially helpful when you have multiple pills. Make sure you understand how to store your medications properly, as some drugs may have strict storage requirements, such as remaining in their original containers, being kept in the refrigerator or stored away from moisture.

Plan ahead for refills

Planning is necessary to make sure you always have your medication when necessary. When you fill each prescription, check the bottle for the number of remaining refills. Call your doctor for a new prescription when one refill is left, or sign up for automatic refills through your pharmacy. If you plan to travel, count your pills to make sure you have enough medication while you’re away and in case you have unexpected travel delays. It’s best to take your medications in their original containers, and when flying, keep them with you in your carry-on luggage. Be sure to take your list of medications with you in case you need to refill a prescription while away.

Smartphone app medication reminders

  • Dosecast – Medication Reminder / free (Android, iOS)
  • Medication Guide / free (Android, iOS)
  • MedCoach Medication Reminder / free (Android, iOS)
  • Med Helper Pill Reminder / free (Android, iOS)
  • MediSafe Meds & Pill Reminder / free (Android, iOS)
  • Pill Monitor Free – Medication Reminders and Logs / free (iOS)
  • Pill Reminder AnyTimer / free (Android)
  • Pill Reminder by / free (iOS)
  • PocketNurse / free (Android)
  • RXmindMe Prescription / free (iOS)
Visit the App Store on iTunes (iPhone, iPod, iPad) or the Google Play  Store on Android devices to find more complete information on these and  other medication reminders. (Use “medication reminder” as your search term).

Talk with family and friends

Family and friends can play an important role in helping loved ones adhere to treatments. Give them access to your medication list and treatment calendar or schedule. They can also help you look for the most appropriate and effective reminder tools, or help you pick up refills of your prescription. Having others give you a gentle nudge when it’s time to take your medications can keep you consistent and let them feel helpful. Friends and family might also offer to help with transportation to your follow-up appointments, take notes about your side effects, or search for financial assistance options. Don’t be afraid to ask for help; adherence is always easier when you have support from others.

Manage your side effects

Patients sometimes cut back or stop taking their oral anti-cancer medications in an effort to avoid side effects. Many side effects associated with anti-cancer treatments, such as fatigue or skin reactions, may be easily managed if treated early. You should tell your doctor immediately about any side effects you experience so your health care team can help you work through them without reducing or stopping your treatment. This will allow you to get the full benefit of the drug while maintaining a better quality of life throughout your treatment regimen. See here for more information about common treatment-related side effects and how to manage them.

Keep follow-up visits

Being open and honest with your health care team is another proven method of improving adherence. Keep all of your appointments for follow-up testing, as your doctor will need to monitor your response to prescribed medications. These appointments should also be used as an opportunity to talk with your doctor about your medication, any side effects you’ve experienced or any trouble you’ve had with adherence.

Adjusting to an oral anti-cancer treatment regimen

Switching to an oral anti-cancer treatment regimen can be a difficult adjustment. Many believe that IV medications are “stronger” or work better than their oral counterparts. This is simply not true. The oral drugs are designed to provide more convenience and control for the patient, while maintaining the same effectiveness. Oral medications also reduce the risk of IV infection and continued damage to veins. However, with this new convenience comes the responsibility for the proper storage, preparation and administration of your cancer drugs, and after you take them, you must watch for reactions and manage side effects. This responsibility may be overwhelming, but remember that you’re not alone. Ask your friends and family to help you keep track of everything, from side effects to how you feel overall. Keeping a journal and sharing it with your health care team can improve the quality of your cancer care and help you maintain your medication adherence.