Why is adherence to treatment important in vertigo?

Medication will not work unless it is taken¹. This may sound obvious, yet every second patient is not taking his/her medication properly. But what does it mean to be adherent?

Adherence is the degree to which a patient follows a doctor’s prescription². As a patient suffering from vertigo, being adherent means having a chance to control and/or reduce vertigo events. Put all the odds on your side:

• Together with your doctor, find the cause of your vertigo. It is very important to understand where your vertigo comes from (link to article 3), as it can be a symptom of many different conditions and diseases. Your doctor will guide you, establish a precise diagnosis, and prescribe the treatment.
• Start the treatment. Initiating the treatment means starting your medical treatment but also adopting the following recommended exercises. It is important to discuss those with the doctor, so he/she can find the best treatment solution for you. You may discuss with the doctor:
  • The benefits/risks of the solution the doctor is offering
  • Your concerns
  • Challenges you anticipate and solutions that may be found

Once you agree to a treatment, start it. It is the first step to manage your condition.

• Follow the instructions of the doctor in terms of dosage and frequency of medicine and exercise: lower-dosage medicine can be inefficient; a higher dosage can be harmful. It is also important to take medicine in the prescribed intervals: if the prescription is for seven pills a week, once a day, taking seven pills altogether in one day does not mean you follow the treatment. If you missed a dose or think you have difficulties with following the treatment in the right way, solutions always exist. Do not hesitate to contact your doctor to discuss them. The same applies to the exercises: if you are prescribed to exercise every day, it is because constant and regular exercises are efficient in the case of a BPPV^4,5.

• Take the treatment as long as it is prescribed. If the doctor prescribes you a treatment for an intended duration, it means that the medicine will be effective only if taken over that duration. Otherwise, it might be ineffective, harmful, or both.  Besides, stopping the treatment may take away all the benefits that you have gotten from it so far. This means that all your effort would have been for nothing.

Do not self-medicate. Medicines taken in the right way may help you; medicines taken the wrong way may hurt you, as it may lead to:

–Strong side effects

– The development of news diseases

Remember that adherence not only means medication adherence. It also means adopting a healthy lifestyle. When a doctor prescribes you a medication and gives you lifestyle advice that may prevent your vertigo events, it means that those cannot function without the other. For example, in case of BPPV, following the prescribed exercises (learn more about exercises) can be as important as taking the medical treatment.

If you experience difficulties adhering to treatment, consult with your doctor. Discuss with him the actions you can put in place to improve your treatment adherence. Never start, discontinue or change a treatment without doctor’s prescription.

References

1. Lindenfeld J., Jessup M. Drugs don’t work in patients who don’t take them’ (C. Everett Koop, MD, US Surgeon, General, 1985). Eur J Heart Fail, 2017; 19:1412–1413.
2. Jimmy B., Jimmy J. Patient medication adherence: Measures in daily practice. Oman Med J 2011; 26(3): 155–159.
3. Kovacs E., Wang X., Grill E. Economic burden of vertigo: a systematic review. Health Econ Rev 2019; 9(1): 37.
4. Cetin Y., Ozmen O., Demir U., Kasapoglu F., Basut O., Coskun H. Comparison of the effectiveness of Brandt-Daroff Vestibular training and Epley Canalith repositioning maneuver in benign Paroxysmal positional vertigo long term result: A randomized prospective clinical trial. Pak J Med Sci 2018; 34(3): 558-563.
5. Bazoni J., Mendes W., Meneses-Barriviera C., et al. Physical activity in the prevention of benign paroxysmal positional vertigo: probable association. Int Arch Otorhinolaryngol 2014;18(4):387-390.