Simplifying The Dosing Schedule Of Prescription Drugs

March 1, 2011

Many older patients, who take an average of seven medicines a day, are so

confused by the vague instructions on prescription bottles that they don't

realize they can combine their medications to take them more efficiently. A new

Northwestern Medicine study shows patients thought they had to take seven

medicines at least seven and up to 14 separate times a day.

" A complex and confusing regimen means people are less likely to take their

drugs properly, and that means they are not getting the full benefits of their

medicine, " said Wolf, associate professor of medicine and of learning

sciences at Northwestern University Feinberg School of Medicine. He is lead

author of the study, funded by the National Institute on Aging, published

February 28 in Archives of Internal Medicine.

Wolf and colleagues have proposed a universal medication schedule that

standardizes medicine prescriptions into doses at four clearly identified

periods of day - morning, noon, evening and bedtime (instead of twice daily or

every eight hours.)

" Standardizing the times to take medicine will help patients safely take their

medicine, make their lives easier and improve their health outcomes, " Wolf said.

He was on the panel of the U.S. Pharmacopeia that recently released guidance for

drug labeling praising the four daily doses approach.

For the study, Wolf and colleagues interviewed 464 patients, with an average age

of 63, at an academic general medicine practice and three federally qualified

health centers in Chicago to see how patients would schedule a typical

seven-drug regimen. The majority of participants were well educated, but nearly

half had low or marginal health literacy skills.

Wolf found people overcomplicate . Even if two drugs were prescribed in the same

manner (one pill twice daily), nearly a third of patients (30.8 percent) would

not take them together. When two drugs could have been taken together but doctor

instructions were written differently (one pill twice daily versus one pill

every 12 hours) 79 percent of patients would not consolidate these medicines and

take them at the same time. If instructions for two drugs were the same with the

only exception that one said " with food and water, " half the patients would not

take the two drugs at the same time.

Low health literacy was the greatest predictor of patients dosing their

medications a greater number of times per day.

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