Navigating Medication Refusal in Long-Term Care Settings

Providers in long-term care facilities are accustomed to patients who, for a variety of reasons, are not interested in or willing to comply with a prescribed course of medication. And sometimes those exchanges can become an issue, especially if the patient becomes angry, belligerent or hostile towards the provider.

Of course, providers understand that medication adherence is critical for patients. When patients don’t comply with a medication regimen, they run the risk of their condition worsening. In some cases, medication non-compliance can lead to hospitalization and even death.

Adherence is imperative, but for some providers and patients, it requires a winding road to get there. 

At UnitedRx, we understand the vital role that medication plays in the lives of patients and the providers caring for them. That’s why, as a trusted long-term care pharmacy partner, we work with our clients to understand and make recommendations related to treatment plans. In addition, we’re available to discuss concerns related to medication use, medication regimens and medication refusal or non-compliance.

When dealing with patients who are refusing to adhere to a medication regimen, it’s important to remember that nursing home residents in particular have a set of rights and protections under state and federal law. Those rights and protections add context to how a medication refusal incident could be handled. 

Patient rights for those living in long-term care facilities include, in part, that they: 

  • Be treated with respect.
  • Be free from abuse and neglect.
  • Be free from restraints.
  • Make complaints.
  • Get proper medical care.
  • Have your family and friends involved.

Those who work in the field know that it’s beneficial to understand the reason behind non-compliance when considering or developing a way to handle or mitigate the situation. 

Patients choose not to comply for a number of reasons, and one may involve affordability. If that is the reason, there may be discounts or alternate regimens available that offer similar results at a reduced cost. 

A provider may also encounter a patient who does not want to comply with a medication schedule due simply to a lack of understanding, be it because of a language barrier, a cognitive impairment or a need for more information related to their condition or the medication being used to treat it.

It’s also possible that patients are wary of a certain medication because of its side effects. Denial is also a powerful force when it comes to medication adherence, particularly when mental illness is involved — according to the National Alliance on Mental Illness. 

Ultimately, it’s important for caregivers and providers to educate their patients on their condition and the medication being used to treat it, to exhibit a level of empathy for a patient’s condition and the emotional or mental challenges that come with it, to set boundaries and enforce them as it relates to medication adherence, and to avoid ultimatums. 

It also helps to document how interactions go with patients who exhibit non-compliant behavior. Not only does it provide a paper trail of efforts that have been used or successful in the past, but it serves as a reference when discussing the issue with physicians and pharmacists — like the team at UnitedRx. 

At UnitedRx, we deliver a hometown pharmacy experience to more than 400 clients across the country. Contact us to learn more about how our approach to treatment can meet the pharmacy needs of your long-term care facility.