Many treatments for breast cancer — including some hormonal therapies, chemotherapies, and targeted therapies — are taken orally (by mouth) in pill form. Although this is more convenient than driving to your doctor's office for an infusion, it can be harder to remember on a daily basis. Research shows that people with cancer often have trouble sticking to their medication plans.
In some cases, not taking your medication as prescribed is simply a matter of forgetting. For example:
- As you get back to the business of daily life, you may find yourself forgetting you need to take a pill.
- As time passes, you're likely to have fewer doctor visits and therefore fewer reminders about your treatment plan.
- If you’re taking more than one medication, it can be difficult to keep track of them all. And some medications can have fairly complex dosing schedules.
Taking your medication as prescribed allows you to get the most benefit from your treatment. Although one year, 5 years, or even more may seem like a long time, many studies have been done to determine how long a medication should be taken to give the most benefit.
To stay on track with medication, it’s often not enough to depend on your memory. Life is busy with lots of competing demands. Even when people think they've remembered to take the pills every day, they can sometimes be mistaken. Research shows that when people with breast cancer reported on how well they stayed with their treatment program, many had stayed on their regimen a lot less than they thought they did.
You’ll want to establish a routine that works for you and safeguards you from forgetting a dose. The following ten tips may be useful to you as you adjust to taking daily medications. We also polled our Community members to ask for insights about what has worked well for them.
Ask your doctor or nurse to put your medication plan in writing and go over it with you
The plan should describe the size and appearance of the pill(s), how often to take it, how to take it (chew, swallow with water, etc.), the best time of day to take it, and whether to take it on an empty stomach or with food. Ask for instructions about what to do if you miss a dose. For instance, if you forget to take a pill in the morning, ask if you should take it later on or wait until the following day. Ask if it is OK to crush the pill if you have trouble swallowing it. Find out if there are certain foods or drinks you should avoid taking with the medication. The plan also should list potential side effects for each medication. If you use an electronic health record, make sure the plan is in there so you can refer to it (it’s easy to misplace a paper copy).
Create a medication diary
Use a calendar, printed notebook, or spreadsheet to keep track of what medications you take at what time each day. Some patient websites offer online calendar tools that can help you do this. For this to be successful, you’ll need to link taking your pills with the added step of writing it down. If you can't remember whether or not you've taken your pills, you can always go back and check.
A print or online diary is also a good place to record any side effects. Community member FindingOptimism explains how this helped her: “For the first three to four months, I kept a log of the side effects each day. This was helpful in two ways: first, I could track that some of the side effects lessened, which encouraged me, and second, I had a good list to discuss with my doctor and look up on the discussion boards.”
Always take medications at the same time, as part of something you already do routinely
If you can attach taking your medications to something you do every day — eating meals, brushing your teeth, getting ready for bed — you’re more likely to remember them.
And choose a time that works for you, says Community member Scrafgal: “Take them at a time of day where you have the most control. For me that’s the morning, before I get all engaged with work. At night, I am tired and would forget or fall fast asleep before remembering.”
For Community member Traii, evening is a better time: “Morning didn’t work for me [due to] the rush of getting ready for work and my son for school. The side effects weren’t working for me during the day either, so I took control and found that nighttime before bed is what works best for me.”
Side effects also prompted GlobalGal to take her pills at night: “My pharmacist and the AI [aromatase inhibitor] bottle warned of ‘dizziness,’ so I decided to take my oral med when I was safely seated on the sofa watching TV at 9 PM (and not walking about or driving).”
Use visual cues
A visual cue can mean simply leaving your medication bottle(s) on the bathroom sink, bedside table, kitchen counter, or wherever you routinely take your medicine. Some people find it helpful to turn the bottle over after they’ve taken their daily dose, and then place it upright later in the evening before bed or the next morning after waking up. You also can post a reminder sign wherever you take your daily dose and add one or two signs in places where you look every day (such as your bathroom mirror, your computer, your back or front door, or your refrigerator). Even a small ribbon on your car’s steering wheel can be helpful.
MDRR says, “Every night when preparing for bed, I set the bottle on the bathroom sink with my ‘morning stuff.’ Once I take the pill in the morning, I move the bottle off the sink.”
“I bought a weekly pill holder and take the pills in the morning,” says FindingOptimism. “The pill holder gives a visual cue in case I have forgotten.”
For ChelseaSculler, the visual reminder is a cookie tin: “I keep a cookie tin of bottles by my bed and take them at night. The cookie tin is because I hate looking at all the bottles; they make me feel like a sick person when they’re sitting on the counter or in the daily plastic pill boxes.”
Take advantage of technology, such as reminder alarms or apps
If you regularly work on a computer and have a calendar with a scheduler, set it to notify you when it's time to take your pills. You also can set your alarm watch to ring when it's time to take your medication. If you have a smartphone, you can set a daily alarm (or alarms) and label it “take your medication.” If you want to go even more high-tech, check out some of the smartphone apps that allow you to enter your medication schedule and receive regular reminders. Some examples include Mango Health, MyMeds, MediSafe, and Dosecast. Major drugstore chains such as CVS also offer medication tracking apps.
Community member Scrafgal sets two phone alarms just to be sure: “I set an initial reminder in the morning and another one just before noon, in case I forgot. This comes in handy on vacations where your routine is thrown off.”
“I use a Fitbit alarm as my nightly reminder and now it’s just a habit: take pills, brush teeth, do lymph-related stretches, go to sleep,” notes Community member Illimae.
ChelseaSculler adds, “I have ‘take pills’ in my habit tracking app, called Strides, so I have a visual reminder of how I’m doing.”
Organize your medications or have an online pharmacy do it for you
If you take several medications at different times, use a pill organizer that has different time compartments for each day. Or use separate AM and PM organizers to keep in different locations in your home. Some of these organizers even light up, ring, or vibrate when you need to take your meds. You can get pill organizers at your local drugstore or shop for them online. Some people find it helpful to use an online pharmacy that bundles the medications in small packs and labels them with the date and time they should be taken. Just two examples are Pillpack.com and CVS.com.
Sign up for automatic medication refills through an online or mail-order pharmacy
This will help keep you from running out of medicine. You'll avoid problems like forgetting to call in a refill or having to go to a pharmacy to pick up your prescription. Some major drugstore chains now offer online ordering and delivery.
Pajim says she found this incredibly helpful: “Every 90 days the new pill bottle just showed up. I didn’t have to order or fetch it. Those were hurdles for me.”
Ask a friend or family member, or someone you've met through a support group, to be your "medication buddy."
This person can remind you about what medicines you need to take and make sure you've taken them. It can be as simple as a daily text or phone call. If the person lives with you, he or she can ask about your meds upon seeing your pill bottles or other visual cues.
Community member gb2115 sometimes depends on her husband for help: “I take my tamoxifen while getting ready for work. I’m very routine with it, take it right before blow drying my hair. [I] take it with a full glass of water and then leave the tumbler on my nightstand. So when I get anxious and can’t remember if I took it, I text my husband to find out if there’s a slightly damp cup on the nightstand. He works from home so he can check for me.”
Find out if you can receive a regular check-in call from your doctor, nurse, nurse navigator, or practice-based pharmacist to review your medications
Some medical practices do make reminder calls to ensure patients are staying on track with their medications. If you suspect you’ll be prone to forgetting medication, ask whether this might be available to you. A regular call is a good opportunity to ask any questions about the medication or its side effects.
Plan ahead for being away from home
If you know you’ll be out when your next dose is due, throw a brightly colored pillbox in your purse so you’ll remember. PurpleCat uses a pill organizer but says she always carries an extra dose in her purse as a backup: “Every now and then I get to work and remember I forgot to take it. So I carry an extra dose so I can take it at work.” If you'll be away for days or weeks, take along plenty of medication in the original container and bring along your pill organizer, diary, or whatever tools you're using. Consider taking along an extra prescription for each medication just in case. If you are traveling by air, keep medication with you in your carry-on bag in case your luggage gets lost.
If you’re changing time zones, you might need to take extra steps to stay on track, says Community member Ciaci, who uses a daily alarm on her phone as a reminder to take her pills: “When I went to Europe a few months ago. I set my phone to keep Eastern Standard Time so I didn’t have to adjust for time zones — I always took them 24 hours apart.”
The bottom line is that you need to find a system that works for you. The more you stick to taking medications as prescribed, the greater the benefits will be in treating the cancer and lowering your risk of recurrence.
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