Medication Compliance

Medication Compliance

Medication Compliance Aids - Medicine cases - Pill boxes - Medical Organizers - Medication box - Medication Reminders - e-pill - CADEX - Pill Timers

Sample Medication Compliance Study:

Treatment Adherence With Lithium and Anticonvulsant Medications Among Patients With Bipolar Disorder

Martha Sajatovic, M.D., Marcia Valenstein, M.D., M.S., Frederick Blow, Ph.D., Dara Ganoczy, M.P.H. and Rosalinda Ignacio, M.S.


Nonadherence limits the effectiveness of medications among patients with bipolar disorder. This study examined adherence with lithium and anticonvulsant medication among patients with bipolar disorder receiving treatment in Department of Veterans Affairs (VA) settings.


Patients receiving treatment in the VA for bipolar disorder during federal fiscal year 2003 (FY03) and receiving lithium or anticonvulsant medication were identified (N=44,637) by using the VA's National Psychosis Registry. Medication adherence was assessed by using the medication possession ratio (MPR) for lithium, valproate or divalproex, carbamazepine, and lamotrigine. Patients were categorized into three groups: fully adherent (MPR greater than .80), partially adherent (MPR from more than .50 to .80), and nonadherent (MPR less than or equal to .50). RESULTS: A slight majority of individuals (54.1%) were fully adherent, 24.5% were partially adherent, and 21.4% were nonadherent. Nonadherent individuals were more likely to be younger, unmarried, nonwhite, or homeless or to have diagnoses of a substance use disorder or fewer outpatient psychiatric visits in FY03. Adherence intensity was somewhat lower for valproate, compared with lithium or other anticonvulsants. Individuals given prescriptions for two agents to stabilize mood had better adherence than individuals given prescriptions for a single agent. Unexpectedly, in multivariate analyses adjusting for prior hospitalization, number of outpatient psychiatric visits, and a diagnosis of substance use disorder, poorer adherence was associated with decreased rates of hospitalization.


Nearly one in two individuals given prescriptions for lithium or anticonvulsant medication to treat bipolar disorder did not take their medications as prescribed. The effectiveness of bipolar medication treatments is reduced by high rates of nonadherence in clinical settings.

Read the Full Medication Compliance Article
Listing of all e-pill Medication Compliance Devices

Patient InformationPatient Information
Did you know that 10% of all hospital admissions and almost 30% of admissions to nursing homes are due to improperly taken prescription medications?

We ( provide practical patient compliance devices and services to patients (individuals and clinics) using the Internet as one of our marketing channels. Click below to learn more:

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COMPLIANCE AIDS. Practical patient adherence medication compliance e-pill® devicesCOMPLIANCE AIDS. Practical patient adherence medication compliance e-pill® devices

Compliance Aids
Medication Compliance Aids

Smart Practical e-pill Medication Reminders may help your patient or aloved one remember to take his or her medications right. Medication Compliance Statistics

Right Medications - Right Dosage - Right Time

Never forget to take your medications again with an e-pill Medication Reminder compliance aid. Pill Box, Vibrating Watch, Automatic Pill Dispenser. All e-pill Medication Reminders come with a 30-Day Money Back Guarantee, One Year Warranty and FREE Standard Shipping & Handling.

Feel Better. Never Forget to take your Medications Again. Avoid Medication Errors.

Patient Compliance: Patients may be noncompliant for many reasons. The most obvious cause is simple forgetfulness, a more likely circumstance if a medication is being used for an asymptomatic condition such as hypertension. Learn more

Keeping Up with Medication Dosage and Frequency is Vital to Your Health ...

.... The patient had been diagnosed with hyperlipidemia, or high cholesterol. The doctor prescribed a statin, a lipid lowering drug. After taking the drug for a while, the patient's cholesterol level came down. He stopped taking his medication.

The patient later began to experience shortness of breath when exercising and some pressure in his chest. Subsequently, he experienced chest pain and had to have open-heart surgery......

.... This patient was former President Bill Clinton.

President Clinton was fortunate. Other patients who stop taking their cholesterol medication, or do not adhere to their prescribed dosages, are not so lucky. In fact, approximately 125,000 deaths in the United States each year are attributed to noncompliance with a doctor's prescription, twice the number of people killed in automobile accidents.

Medication Compliance / Patient Adherence is the practice of taking your medication as your physician prescribed it.

50% of people presently on medication do not take it as prescribed

To be Non-Adherent means you have, for some reason, deviated from the course the doctor prescribed. Perhaps you take your medicine only occasionally, perhaps you never filled your last prescription; perhaps you never took it at all.

Do not be surprised if this describes you. In fact, This is a serious problem in today's world because medication non-adherence causes health complications (subsequent ailments, more doctor visits, lost work, trips to the hospital, etc.) that ripple out across our health care system costing approximately $177 billion a year in addition to the immeasurable amount of pain and loss of life.

C. Everett Koop, the former U.S. Surgeon General: "Drugs don't work if people don't take them."

The most common types of noncompliance include:

  • Not having a prescription filled
  • Taking an incorrect dose - too much or too little
  • Taking the medication at the wrong time
  • Forgetting to take one or more doses
  • Stopping the medication too soon

    According to the World Health Organization, the noncompliance rate for long-term therapies averages 50 percent. Boston Heart Party™ results from last spring's annual enrollment health fairs suggest that GIC enrollees may not be compliant with their heart medications or are not under treatment for their cardiovascular disease risk.

    More than 1,600 GIC enrollees took advantage of the free screenings. Although participants may not mirror the entire GIC population, and fasting tests provide more accurate cholesterol and glucose readings, over 50% of GIC enrollees taking the test reported having a known risk factor for heart disease and many of these same people still exhibited "at risk" screening results, which suggests that they may not be following doctors recommendations (the GIC received only aggregate data).

    High Blood Pressure (Hypertension):

    High blood pressure, or hypertension, is very common, affecting over 18 million workers in the United States. According to the National Health Information Survey, 35% of those with hypertension have not been diagnosed. Known as "the silent killer", high blood pressure is a condition in which the pressure of the blood in the arteries is too high. The normal range is 120/80 mm Hg (millimeters of mercury). If your pressure is consistently above this range, you have high blood pressure and are at risk of a heart attack, stroke and kidney disease. The top (systolic) number measures the pressure when the heart beats. The bottom (diastolic) number is the pressure when the heart is at rest.

    The Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure defines high blood pressure for non-diabetics as 140/90 or more. Of the GIC enrollees screened at the fairs, 26% of women and 44% of men had high blood pressure readings. Prehypertensive (at risk for high blood pressure) means the systolic number is between 120-139 or the diastolic is between 80-89. Of the GIC enrollees screened, 60% of women and 68% of men had prehypertensive blood pressure readings.

    High Cholesterol (Hyperlipidemia):

    Over 37 million American workers have hyperlipidemia. Like high blood pressure, many Americans are unaware that they have high cholesterol. Forty-one percent of those with hyperlipidemia have not been diagnosed. Cholesterol travels in the bloodstream in the form of various-sized particles known as lipoproteins. Elevated cholesterol means that you have more cholesterol in your blood than your body needs. Total cholesterol levels should be under 200 milligrams per deciliter (mg/DL), according to the National Institute of Health. Fifty-two percent of GIC women screened had total cholesterol levels greater than 200, including 17% with levels above 240. Forty-four percent of GIC men had total cholesterol levels greater than 200, including 13% with levels above 240.

    High Blood Sugar (glucose):

    Four percent of the workforce has diabetes, which is indicated by high blood sugar levels greater than 126 (mg/DL). Forty-one percent of workers with diabetes are undiagnosed. Levels of glucose rise in the blood because the glucose is not getting into the body's cells. Diabetes more than doubles your risk for a stroke or heart disease. Although fasting is necessary to get the most accurate glucose readings, levels greater than 199, with or without fasting, indicate a need to seek treatment immediately. Fifteen percent of GIC women and 21% of GIC men had glucose levels greater than 126. One percent of GIC women and 3% of GIC men had readings greater than 199.

    So why do patients not follow their prescribed drug regimen for lowering risk for heart disease? A 1999 study published in the Journal of the American Geriatrics Society identified 26 factors that lead to noncompliance. Compliance decreased as the complexity, cost and duration of the medication regimen increased. Patient-related factors that contribute to noncompliance include lack of social support, an unstable living environment, mental illness, limited financial resources, denial of the illness, and low perceived susceptibility to the disease.

    The busiest patients were found to have the lowest rate of compliance. Poor communication between the patient and his/her provider also led to noncompliance.

    Patients must take their medication as prescribed in order for the medication to be effective. Failure to do so can cause side effects that may be mild -- or potentially fatal. The American Heart Association recommends the following tips for remembering to take medication as prescribed:
  • Take it at the same time every day; take it along with meals or other routine daily events
  • Use special pill boxes, such as the one divided into sections that can be found at most drug stores
  • Keep a medicine calendar, or use a white board or sticker system to record your medications
  • Work with your doctor to develop other tools to help you keep up with your drug regimen.
  • NEVER stop taking your medication without first talking to your doctor.

    Learn more Keeping Up with Medication Dosage and Frequency is Vital to Your Health (click here)

  • STATISTICS Patient Compliance Medication Adherence STATISTICS Patient Compliance Medication Adherence

    Patient Compliance
    Medication Adherence
    Medication Non-Adherence
    Statistics & References

    Compliance means taking the correct amount of the prescribed medicine at the proper time. See all e-pill Medication Reminders.

    Key Stats on Medication Adherence (PhRMA 2011) | What is PDC? 'I Never Miss a Dose'?

  • 32 million Americans use three or more medicines daily
  • 75% of adults are non-adherent in one or more ways
  • The economic impact of non-adherence is estimated to cost $100 billion annually

  • The average adherence rate (the degree to which patients correctly follow prescription instructions) for medicines taken only once daily is nearly 80 percent, compared to about 50 percent for treatments that must be taken 4 times a day. As many as 75 percent of patients (and 50 percent of chronically ill patients) fail to adhere to, or comply with physician prescribed treatment regimens.

    CVS Report on Adherence PDF Rx Adherence

    In a recent poll of U.S. individuals 65 years old and older who use medications, researches found that 51% take at least five different prescription drugs regularly, and one in four take between 10 and 19 pills each day. 57% of those polled admit that they forget to take their medications. Among those using five or more medications, 63% say they forget doses, compared to 51% among those who take fewer medicines. (10)

    Drugs don't work in patients who don't take them

    C. Everett Koop, MD

    Remembering to take your medicine is the key to compliance. Medicine will be effective only when taken as prescribed by your physician. Professional Info

    The Real Drug Problem: Forgetting to Take Them WSJ - Amy Dockser Marcus article
    Good patient compliance and adherence means taking the right drugs, on time and in the proper doses. Distant Caregiving | Links | Professional info | e-pill Medication Reminder catalog | Help to select the right Medication Reminder
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    Patient Compliance: Medication non-compliance (non-adherence), the failure to take drugs on time in the dosages prescribed, is as dangerous and costly as many illnesses.

    Want to Improve Patient Compliance? Five Tips for Generating Patient Satisfaction and Compliance

    Get Medsmart: Despite the fact that medications can save or extend lives, the average patient fails to follow her/his pill prescription half the time.

    The reasons behind this failure are varied; ranging from simple forgetfulness to confusion to ambivalence, but the problem costs an estimated $290 billion in emergency-room visits and other avoidable medical expenses in the United States (11).

    Studies have shown than non-compliance causes 125,000 deaths annually in the US (2), leads to 10 to 25 percent of hospital and nursing home admissions, and is becoming an international epidemic. It is, in the words of The New York Times (1) the world’s "other drug problem".

    Negative Economic Effects of Non-Compliance

    · 23% of nursing home admissions due to noncompliance(3). Cost $31.3 billion / 380,000 patients.

    · 10% of hospital admissions due to noncompliance (4,5). Cost $15.2 billion / 3.5 million patients.


    · About 50% of the 2 billion prescriptions filled each year are not taken correctly (7).

    · 1/3 of patients take all their medicine, 1/3 take some, 1/3 don't take any at all (Rx prescription never filled) (6).

    Care Giving

    · 25,000,000 nonprofessional caregivers in the US (8).

    · 80% of nonprofessional caregivers are women (8).

    · 80%-90% of people requiring care in the US receive it from family members or friends (9).

    Merck Manual on ways to Improve Patient Compliance (Medication Reminders & Pillboxes)

    World Health Organization. Adherence to Long-Term Therapies Adherence Report)

    Bridge Medical. Medication Error References Medication Errors and Medication)

    1. The New York Times June 2, 1998 2. Smith, D., Compliance Packaging: A Patient Education Tool, American Pharmacy, Vol. NS29, No 2 February 1989 3. Standberg, L.R., Drugs as a Reason for Nursing Home Admissions, American Health care Association Journal, 10,20 (1984). 4. Schering Report IX The Forgetful Patient: The High Cost of Improper Patient Compliance. 5. Oregon Department of Human Resources, A study of Long-Term Care in Oregon with Emphasis on the Elderly March 1981. 6. Hayes, R.B.NCPIE Prescription Month, October 1989 7. National Council for Patient Information and Education. 8. Rosalynn Carter Institute of Georgia Southwestern College. 9. Parade Magazine, 1/29/95. 10. Med Ad News February 2010 11. New England Healthcare Institute

    Professional INFOProfessional INFO

    Pharmacists, Doctors (MD) Nurses (RN), Nurse Practitioners, Physician Assistants (PA), Social Workers and Therapists.

    Information about e-pill devices for Healthcare Professionals: Pharmacists, Doctors (MD) Nurses (RN), Nurse Practitioners, Physician Assistants, Social Workers and Therapists.
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    ... Perfect health and compliant patients! ... A wonderful dream, but unreal for most of us. | Medication Adherence for the Practice of Pharmacy | Features e-pill Automatic Dispensers | e-pill Videos | PRODUCT Finder |

    Non-Adherence is the major controllable cause of preventable rehospitalizations.

    In a poll of U.S. individuals 65 years old and older who use medications, researchers found that 51% take at least five different prescription drugs regularly, and one in four take between 10 and 19 pills each day. 57% of those polled admit that they forget to take their medications. Among those using five or more medications, 63% say they forget doses, compared to 51% among those who take fewer medicines. | Home Page ( | Clinical Studies | Proportion of Days Covered Definition | Pill Dispenser Pharmacy Filling Program | Link Productivity / Medication Adherence | Published Data | CAGE Questionnaire | Portable Automatic Pill Dispenser used in Kidney Transplant Organ Rejection Study.

    Drugs don’t work in patients who don’t take them
    C. Everett Koop, MD

  • Failure to comply with medication regimens is a major health care problem.
  • 1.6 billion prescriptions are written every year in the United States. Source: National Council for Patient Information and Education, Washington, DC. Compliance Statistics

    e-pill is the leading provider of practical patient compliance
    and medication adherence devices.
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    Please request (by e-mail) our "tear-off pad" (like a prescription pad with a mail-order form on the back) listing our most popular patient compliance / medication adherence devices. The "prescription" also has room for your professional recommendations and comments. | e-pill On-Line Catalog | HIProtector Hip Protectors | e-pill CADEX devices.

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    e-pill Patient Compliance Devices:

    CADEX 12 ALARM Medication Reminder Timer and Medical ALERT IDCADEX 12 ALARM Medication Reminder Timer and Medical ALERT ID

    CADEX Alarm Watch (max 12 Daily Alarms) and Medication Reminder.
    e-pill® CADEX® Alarm Timer Watch.

    CADEX® 12 Alarm Watch with Alarm Bank and Medical Alert Data Bank.

    E-pill CADEX is our most popular alarm watch (Medication Reminder and Medical ID Bracelet). Scroll down to see all CADEX designs and models. | Visit CADEX Alarm Wrist Watch Web site. Over 50,000 CADEX Alarm Watches Sold! Watch a Short CADEX Video to see how it works. Listen to the Medical Alert CADEX Radio Ad | See e-pill CADEX Inventor Video. Manual | Recommended by Good Housekeeping. They call it a TOP CHOICE and EASY to PROGRAM.

    Shown by Dr Oz on Good Morning America. Learn more: Dr Oz e-pill CADEX video.

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    Order e-pill CADEX: Silver | Black | Expansion Band | Pediatric (for Children) | Leather | COIL (for Children) | CARABINER (Pocket/Purse Watch) | AGENDA (Alarm Watch + Weekly Pill Organizer)

    VIDEO: CADEX Quick Guide
    How does the CADEX work? Watch YouTube Video

    With up to 12 Daily ALARMS, Medical Snooze and a Medical ALERT ID databank, the e-pill CADEX Medication Reminder Alarm Wrist Watch (7 designs - see below) takes the worry out of taking medications, so you can spend your time enjoying the more important things in life. Features the e-pill Medical Snooze function.

    Choose the right CADEX / CADEX Accessory for you or your patient:

  • e-pill CADEX LEATHER 12 Alarm WATCH & Medical ALERT SILVER with Brown Leather Strap.
  • e-pill CADEX 12 Alarm WATCH & Medical ALERT SILVER with Black Strap.
  • e-pill CADEX 12 Alarm WATCH & Medical ALERT BLACK with Black Strap.
  • e-pill CADEX 12 Alarm WATCH & Medical ALERT Expansion Band (watch color Silver).
  • e-pill CADEX 12 Alarm PEDIATRIC WATCH & Medical ALERT BLACK with RED/Black Velcro Strap (adult size watch with Velcro strap adjusts to the growing child's wrist).
  • PENDANT (around your neck, not on your wrist) Pendant Conversion Kit.
  • e-pill CADEX CARABINER 12 Alarm TIMER & Medical ALERT BLACK Clip Watch.
  • e-pill CADEX COIL 12 Alarm TIMER & Medical ALERT RED Coil Pocket Watch.
  • e-pill CADEX AGENDA 12 Alarm TIMER & Medical ALERT Alarm Watch + PILBOX Carry-All incuding Patient Diary, Weekly Pill Organizer x 4 Doses and Pen

    Not Suitable for Hearing Impaired
    Do not wear in shower or swimming pool

    This e-pill device is member tested & recommended by National Health & Wellness Club. Quick Set-Up Guide | Instruction Manual | Other e-pill Manuals

    Suggested retail price $250.00 On SALE now | U.S. Patent 6,560,165 CADEX®, ePill® and e-pill® are registered trademarks. Visit CADEX Web site. Scroll down below to see all CADEX Alarm Watches and CADEX Alarm Timers:

    The CADEX Medication Reminder takes the worry out of taking daily medications, so you can spend your time enjoying the more important things in life.

    Never Forget to take your Medications Again!
    Feel Better. Avoid Medication Errors

    TIMER WATCH: The CADEX wristwatch has up to twelve (12) daily alarms (medication reminders). The alarms auto repeat every day, no reset required. At the scheduled time (same time every day), the alarm will sound and display the name of the medication to be taken.

    What is Medical Snooze?

    This e-pill nags you! A unique Medical Snooze feature allows you to turn off the initial beeping and continue to be reminded with a subtle double beep every three (3) minutes until you have taken your all your medications (for up to 4 hours).

    MEDICAL ALERT: In addition to being a great medication reminder the Emergency ALERT Data Bank stores your critical health information, similar to a Medical Alert I.D. Bracelet. Pressing the ALERT button on the alarm watch will display the following MEDICAL ALERT Information: | How to ERASE Information

  • Your NAME and Phone number
  • Medical ALERT Conditions (i.e. diabetic, pacemaker, hemophiliac, Parkinson's, HIV/AIDS, epilepsy, etc.)
  • ALLERGIC (i.e. penicillin, bee stings, peanuts, etc.)
  • Current Medications
  • DOCTOR's Name and Contact information
  • Emergency CONTACT Name and Phone number
  • BLOOD Type
  • BIRTHDAY Date of Birth
  • INSURER Health insurance company and phone number
  • POLICY # Health insurance policy number
  • S.S.# Social Security number (optional)
  • (hidden field - see below)

    Taking medications on time and in the prescribed doses allows you to experience the full effectiveness of your medication. Learn more about: Medication Compliance / Patient Adherence.

    Learn about CADEX & Epilepsy | CADEX & Incontinence

    Hidden field: This field will not be displayed when you press ALERT: Credit Card and Expiration Date (see instructions how to get to this hidden information).

    Be healthy, ease your mind, order your own e-pill CADEX 12 Alarm Watch & Medical ALERT today. CADEX is Member Tested & Recommended

    Order e-pill CADEX: Silver | Black | Pediatric | Leather | Coil | Clip (Pocket Watch)

    CADEX Wristwatch FEATURES:

  • 12 Daily ALARMS with Optional Text (messages up to 36 characters long)
  • Medical ALERT (medical ID)
  • Emergency identification. Provides immediate important health information to medical personnel in an emergency situation when you can not speak for yourself
  • Medical SNOOZE
  • Long Alarm duration (60 seconds plus reminder beep / up to 4 hours)
  • Standard Size sports style watch (1 1/2 inch Round)
  • Fits Men, Women or Kids (pediatric)
  • Pendant conversion kit available for those who do not wish to wear the watch on their wrist
  • Easy to Set and Use
  • Easy to Read Display
  • Time and Date
  • Recommended by Doctors, Nurses and Pharmacists
  • Recommended by Good Housekeeping
  • Water and shock resistant (do not wear in shower or swimming pool)
  • Used in Clinical Trials

    Risk Free Purchase / 30 DAY MONEY BACK GUARANTEE:

    When you purchase a CADEX alarm watch we recommend that you program the watch and make sure you like the style and ease of use. If you do not, return it promptly in its original packaging for a complete refund.

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    We offer FREE Standard Shipping for all our U.S. Customers. To take advantage of this offer please select STANDARD Shipping at check-out. We also offer several other shipping methods including OVERNIGHT Shipping (extra charges apply).

    One Year WARRANTY:

    The e-pill CADEX watch comes with a One (1) year warranty guaranteeing its inner components. This does not cover the band, buckle, battery, case, buttons or crystal. During the warranty period and upon proof of purchase, the watch will be repaired or replaced free of charge (please contact your dealer). If you purchased your CADEX watch directly from the manufacturer (e-pill, LLC), please call us toll free at 1-888-726-8805 (+1 781-239-8255). We look forward to assisting you
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