Nearly half (46%) of people don't always take their medication as instructed, according to new research.

Less than a third (30%) of people with long term conditions said they felt 'confident' about the way they manage their medicine and with over 15 million[1] people in England suffering from a long term condition such as diabetes, heart disease and arthritis, this means that millions of people could be putting their health at risk by not taking their medicine properly.

The research, carried out by the community pharmacy chain LloydsPharmacy looked into why people don't take their medication properly and the difficulties they face. It found that almost 8 in 10 of participants didn't take their medicine as prescribed due to forgetfulness. Nearly two thirds (61%) admitted to not taking their medications at the right time of day and nearly a third (30%) admitted to either taking more or less of their medication than instructed.

Not taking medication as prescribed can not only make it less effective and interfere with its ability to treat the condition but it can also lead to greater complications from the illness, increase the risk of side effects from the medication itself and can lower the quality of life for patients.

The findings are supported by observations from LloydsPharmacy pharmacists, 24% of whom reported seeing patients at least once a week who aren't taking their medication properly.

Nitin Makadia, pharmacist at LloydsPharmacy, explains the help that is available for patients: "We're urging anyone concerned or confused about their medicine to talk to their pharmacist as it's vital that people with long-term conditions take all their medications as prescribed for the sake of their long term health. As a pharmacist it's extremely worrying to find that so many people are struggling to stick to their medication plan. Juggling multiple medications can be a real challenge but using repeat prescription services and taking part in medicine check-ups at a pharmacy can help people take control."

With the onset of an ageing population, increasing numbers of people are being diagnosed with long term conditions and many of these individuals are on multiple medications. Currently there are at least 15.4 million people in England with a long term condition and the numbers of people with three or more long term conditions is expected to rise from 1.9m to 2.9m by 2018.[2] This means that medicine non-adherence and the pressure it places on the NHS is likely to grow considerably in the coming years - last year the Aston Medication Adherence Study (AMAS) found that people not taking their medication as instructed could cost the NHS more than £500 million every year.[3]

LloydsPharmacy also carried out research among its own pharmacists into medicine mis-management among patients[4]. When asked what the most common reasons patients gave for not taking their medicines correctly, the top three answers were because of a lack of understanding about the need to take it, simply forgetting and worries about the side effects - which could be addressed during a medicine check- up with a pharmacist. Other reasons patients gave included not liking the colour or size of the pill and being too busy and simply deciding themselves not to take it anymore.

LloydsPharmacy has these top tips to help people manage their medicines:

Create a timetable stating which days and times you need to take your medication and out it somewhere clearly visible, like on your fridge.

Use a pill box - as well as helping you remember this can also help ensure you take the right dose.

Make taking your medicines part of your daily routine by tying it in with a daily task such as using the computer or watching TV.

Your family can support you - tell members of your family when you should be taking your medicines so they can help to remind you if you do forget.

Keep medicines that are supposed to be taken with or after food in the morning by your kettle or toaster and those that should be taken at night on your bedside table.

Nitin Makadia, pharmacist at LloydsPharmacy explains the importance of taking medicines as instructed

Diabetes: There are a range of prescription medicines available to treat diabetes and they all work in different ways to treat the condition and therefore are required to be taken at various times of the day. For example sulphonylureas such as gliclazide should be taken with breakfast, and biguanides such as metformin can be taken at any time of the day so long as it's taken with or just after food. The reason why these medicines should be taken with or after food is to avoid the patient becoming hypoglycaemic, where too much sugar is excreted from the body leaving the patient with dangerously low levels of sugar in their blood.

Anti-inflammatory drugs: These include medicines like ibuprofen and can cause heartburn and indigestion and in the longer term can even cause stomach ulcers so it's important to take them with or after food. If people do experience symptoms of indigestion or heartburn it's important to seek the advice of a pharmacist or a doctor. Those people who take these medicines long term should also take a medicine called a PPI which helps to protect the stomach from these side effects - I would advise people speak to their pharmacist or doctor to understand if this is appropriate for them.

Cholesterol medication: Cholesterol is produced by the liver. Statins work by making the liver reduce its production of cholesterol. Some types of statins should be taken in the evening. This is because your liver makes most of the cholesterol in your body at night. But other types of statins can be taken at any time during the day.

Medicine absorption: Some medicines are designed to be absorbed in different parts of the body so taking them with food when you're not supposed to or not taking with food when you're supposed to can prevent them from reaching the right part of the body at the right time, reducing their effectiveness. Many medicines will say on the label if they should be taken with or without food and for those that don't specify it is usually best to take them on an empty stomach so they can pass quickly to the area of your digestive tract where they can be absorbed. For example:

  • Penicillin is broken down by stomach acid so taking it with food will make it less effective as food stimulates stomach acid production. It is best taken on an empty stomach.
  • Iron tablets are also better absorbed by an empty stomach although they can be taken with a small amount of food but never antacid, milk or dairy products as it binds with the iron which stops it from being absorbed.

Blood pressure tablets: There are a range of prescription medicines available to help control blood pressure and therefore different rules around when they should be taken. For example, diuretics encourage the body to get rid of fluid which in turn helps to reduce blood pressure. It is best to take this group of medicines in the morning so that it isn't disruptive or causes an inconvenience to the rest of the day.