It’s April and tax time, a time when many of us are reflecting on last year’s financial successes or woes.  This can be a stressful time for many of us in a ‘normal’ year.  But these past few years have been full of stories about lives impacted by financial turmoil.  Compounding everything is the looming federal budget crisis.  Just a few weeks ago, stories of the closure of government dominated the news.  We heard about service persons not receiving their paychecks, passports not being processed, phones unanswered and more.  I’m sure that many of America’s elder citizens worried about the arrival of their social security check or  cuts in their Medicare coverage.  Despite assurances of essential services continuing, the government shut down conjured up many fears real and imagined.  Our older patients may still be feeling helpless and hopeless about the future of these safety net programs.

The elder patient doesn’t need to remind us that they are on a fixed income (although many do).  This alone can cause much anxiety for them.  I bring this up because in our current economic climate, we may be seeing an increase in patient medication non-adherence.  In good times, a common reason for medication non-adherence is the cost of medications.  I wonder if incidences of non-adherence due to financial reasons will be increasing much more now.  Interventions are possible if an adherence assessment reveals that a patient isn’t filling prescriptions or is limiting or altering medication use to save money.  Working with the physician to eliminate unnecessary medications and changing to generic equivalents are a few of the ways to help.

Financial issues are only one of the reasons for medication non-adherence.  There is a large body of evidence on this topic.  CHAMP will be offering a new course this month, Patient Adherence.  The course will focus on skills to promote positive adherence, tools and strategies for addressing non-adherence and much more.  The more we learn about this subject the better prepared we’ll be to assist our patients and possibly our own elder family members as well.

Debra Bertrand, CHAMP Facilitator