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The study of adherence, or pill-taking behavior in patients, has existed for centuries. Most of the work has been done looking at the Infectious Diseases (tuberculosis, HIV etc.). However, these findings are equally applicable to other disciplines of medicine, such as Psychiatry, where patients/consumers are also required to follow complex medical regimens. Consumer education, and the development of a trusting relationship with one's physician, is essential when attempting to optimize medication adherence.

To the extent possible, the drug regimen should be simplified by reducing the number of pills and the frequency of therapy. This will also minimize drug interaction and side effects. Consumers should review their daily schedule with their physicians and attempt to identify "markers" that will make it easier to remember to take medications (ex. the relationship to meals, work, bedtime etc.).

Sometimes, a written schedule, or even pictures of the pills (provided by some pharmaceutical companies), help improve adherence. Daily or weekly pill-boxes, beepers, alarm watches or other mechanical aids can also be extremely useful as reminders, and are often available in local pharmacies. As a general rule, it is recommended that consumers count and sort their pills every week. They should keep an extra dose of medicines in their briefcases, purses, etc. in the event they have a sudden change in schedule. They should plan ahead for vacations and holidays. It is advisable to know, or keep a copy of the telephone number of one's physician at all times, and of his/her beeper number, in case of emergencies. Also consumers should make sure they are knowledgeable regarding their physician's vacation/conference coverage.

Knowing one's pharmacist, and using the same pharmacy to fill all prescriptions can help optimize adherence. Pharmacists know side-effects and drug interactions, and can be a valuable source of information for the consumer. If prescriptions are filled repeatedly at the same pharmacy, it will usually have a computerized record of the medicines the consumer has taken in the past, and is taking at present. One should aim to refill their prescriptions one to two weeks before they run out. This affords some leeway should the pharmacy experience difficulty filling the prescription (ex. the pills are not in "the house"). Becoming a regular customer at a particular pharmacy will usually guarantee that the pills are always available, unless the physician changes the medicines substantially. If a consumer is on a stable regimen, and if frequent co-payments are interfering with adherence, he/she might ask the doctor about the possibility of receiving larger prescriptions (ex. two-month supply)

Consumers who are finding it particularly difficult to adhere to their medication regimens should inform their doctors. They may need to increase the frequency of their visits at least temporarily. It may also be possible to mobilize other health care providers (ex. therapists, pharmacists, peer educators, etc.) to assist in improving adherence. Consumers might consider starting support groups on adherence, or might consider adding this topic to the agenda of ongoing support groups.