Adherence: Keeping up with your meds

May 2008     View PDF     En español

Strategies for adherence

Adherence strategies may not work for everyone. Because of cultural, gender and socio-economic differences, these suggestions are more appropriate for some people than others. Different issues are more important in some settings than others.

For example, some people have a great need for privacy around their HIV status and taking medicines. This places greater emphasis on planning ahead for moments of privacy each day. For people struggling with lack of housing, active drug use or untreated mental health conditions, adherence strategies will often go beyond what we cover here. Still, even in the most challenging situations, people have daily routines that can be used as triggers for taking meds.

Adherence strategies can and must vary from person to person. The best way to ensure success is your motivation and commitment to your regimen. It may help to know that many people have accommodated long-term treatment in their lives. People with chronic illnesses have long shown that it can be done. It may take a few tries before you find the approach that works best for you.

Some of the following strategies and tools have worked for many people taking HIV therapy:

• Integrate your regimen into your daily routines. Most people find it easier to fit medicines into their lives, rather than scheduling their lives around their medicine. Use a daily activity, one that you do every day without fail like brushing your teeth, to prompt you to take your meds. Take them before the activity; it’s easier to remember.
• Count out all your meds in daily doses for a week at a time. Use a pillbox, Mediset or nail organizer from a hardware store to hold each dose. Setting up a weekly pillbox also needs to become routine. Meds can also be divided daily by dose and put in separate bags or canisters marked with the dosage times — some use film canisters. Some people put each canister near the place they’ll take a dose. For example, put the morning dose by the coffee pot, and evening dose by the TV.
• Keep a checklist or diary for doses that you’ve taken with a space to note how you’re feeling.
• Use an electronic pillbox or beeping alarm to remind you when to take your meds. The downside of these mechanisms is that the electronic pillboxes are too small and the alarms may be very obvious.
• Use a daily planner, especially at the start of a new regimen. Inserting your dosing requirements into a planner, as if they were appointments, can be a useful reminder. Others use hand-held computers or electronic organizers to remind them of daily doses. These kinds of devices can be bought for under $50.
• Evaluate your regimen about two weeks after you start it. It may take a few weeks of experimenting to figure out how to best schedule your meds with other events in your life. For this reason it may be useful to start a dry run of therapy with small candies, allowing time to adjust your routines before actually taking the drugs.
• Plan ahead for weekends, vacations or moves. People often miss doses when they’re away from home. For most, weekends are different from normal weekday routines, so it’s important to plan ahead. Take into account the changed environment. Will you feel comfortable with your normal routine or will you need other strategies?
• Keep all your meds with you when you travel. Baggage can be lost or delayed.
• Plan ahead for privacy if you need to hide the fact that you’re taking meds. In this situation, try to find at least one person with a similar problem with whom you can discuss strategy. You could adjust your lunch or break schedule to ensure privacy or keep water in your bedroom at all times.
• Keep a diary. Include whatever is important to you: when you took treatment, reason for missed doses, how you feel, etc. Keeping a record like this reminds you how well, or poorly, you‘re doing with adherence.
• Use your support network to remind you of your medication needs. Some people have a treatment buddy who can make daily reminder phone calls.
• Set up a support network for your emotional needs. It’s hard to take treatment and also deal with daily stress, whether it’s taking care of children, working or dealing with illness.