Episode 6 — Mum hides the blister in the drawer. Five reasons we knowingly don't take our medicines

Remember those seven boxes of my mum's? The ones from the carrier bag?

Irina's, I remember.

Well, a week later I went through them again, and one blister pack, nearly full.

A medicine she'd been given a month ago, one she's meant to take every day.

And out of the strip, three tablets, out of thirty.

So she wasn't taking it?

She wasn't. And here's the strange part. It's not that she forgot.

I asked her straight out. She said,

That tablet doesn't agree with me, so I just gave it a miss.

Hello. I'm Tomasz Szuster. I built the mojApteczka app.

And what Ita has just described is what today's whole episode is about.

Not, I forgot to take my medicine. We did that one last time.

Today's harder. Why people knowingly don't take their medicines the way the GP prescribed.

Knowingly? So someone actually sits down and decides not to take it?

Very often, yes. There's a distinction. You can miss a dose because it slipped your mind. That's one thing.

Or you can miss it because you decided to.

Tuck the blister pack away in a drawer.

And that second kind is far more common than you'd think.

How common is more common?

The World Health Organization put a number on it years ago.

With long-term conditions, in countries like ours, roughly half of patients don't take their medicines as prescribed.

Half.

Half. That rather sounds like the whole system's broken, doesn't it?

And here's the catch that surprised me when I was building the app.

At the start, I thought it was a memory problem.

That a good reminder would sort it.

Phone goes off at eight.

You take your tablet.

Job done.

And it doesn't?

It doesn't.

Because a reminder only fixes that one reason.

That you forgot.

And as it turns out, people don't take their medicines for at least five completely different reasons.

And an alarm clock helps with none of them.

Go on then.

Name the five.

Because so far, I know one.

Mums.

It makes me feel poorly.

That's the first, and probably the most common.

Fear of side effects.

Someone takes a medicine, feels a bit off,

or even just reads the leaflet and gets frightened by that long list.

And quietly stops.

Without telling anyone.

Quietly is right.

Mum didn't tell me.

I worked it out from the blister pack.

And let me be clear straight away.

I can't tell you whether that medicine is safe or not.

The app doesn't know, and neither do I.

That's for the GP or the pharmacist.

The app does one thing.

It keeps a list of what Mum takes and what she won't touch.

So you've got something to ask about, instead of guessing.

So not stop it or keep taking it, more you've got a reason to ring the GP.

Exactly.

A quiet decision turns into a conversation.

Right.

Reason two.

Money.

That's the reason nobody says out loud, because there's a bit of shame in it.

A medicine's expensive.

A pensioner's counting every penny.

So they take it every other day, or split the tablet in half, to make it last.

My mum did exactly that with one of hers.

Why buy it every month when I can stretch it out?

And again, the app won't make a medicine any cheaper.

That I can't do.

But it can do one thing.

It shows the active ingredient.

And sometimes the same ingredient comes in a cheaper box, under a different name.

One thing, though.

Whether a swap is right in any given case, that's for the pharmacist at the counter, or the GP, to say.

The app doesn't suggest a substitute in their place.

It just gives you a starting point for that chat at the pharmacy.

So it shows you what to ask, not what to buy.

What to ask.

The choice stays with the pharmacist or the GP.

Third.

I feel fine, so why should I take it?

That one's lethal, especially with high blood pressure.

Because high blood pressure usually doesn't hurt.

You don't feel a thing.

So your head tells you, if I can't feel anything, I must be well.

I'll skip it.

That one I actually understand.

I'd think the same.

It doesn't hurt, so why bother?

And honestly, there's no app that can fix that one.

What you're taking a medicine for, that's for the GP to explain, in the surgery, when they prescribe it.

The only thing I can do in the app is give you a place for a note.

What it's for, who prescribed it.

So that three months on, it's not, that pink one, what's that for again?

So something of that conversation with the GP survives, not just the box?

Yes, because the box doesn't remember why you bought it.

Fourth.

This one's the quietest of all.

Shame and low mood.

Sometimes a person doesn't take their medicines because they feel so low, they simply can't be bothered to look after themselves anymore.

And sometimes they're ashamed of the medicine itself, especially anything for mental health.

There's nothing wrong with my head.

That's a delicate one.

Very.

And that's why one thing is an iron rule for me.

The app never judges anyone.

There's no red banner saying, you've missed it again, you've failed.

There's a counter.

Dry as anything.

Two of four today.

That's it.

No commentary.

No punishment.

No sad face.

I remember.

You said that with Leon's antibiotic.

Shame versus the counter.

Because shame tells you to hide the blister pack and say nothing.

A counter just shows the fact.

And a fact is something you can take to the GP.

Shame stays in the drawer.

And the fifth.

Simply too many medicines.

Back to your Mun's seven boxes.

When you've got seven packs in front of you, each at a different time, one before food,

one after, one only at night, at some point you give up.

You take the ones you remember and let the rest go.

Not out of defiance.

Out of sheer overload.

That's true.

Mum said it outright.

I get lost in all this, so I take the important ones.

Except she decided herself which ones were important.

And that's not a call a patient should be making alone at the kitchen table.

Which brings us back to the report for the GP.

Because only when the GP sees the whole list at once can they judge.

Whether something can be changed, simplified or stopped.

That's their call.

Not mums at the kitchen table.

And not the apps.

The app doesn't stop anything.

It shows the whole picture, so there's something to talk about in the first place.

You know what I like about all this?

That every other minute you say, the app won't do that.

Because it won't.

Look, of those five reasons, the app honestly touches maybe one.

The overload one.

The chaos.

Because it puts the list in order and reminds you.

It won't soothe fear.

It won't fix money troubles.

It won't explain what a medicine's for.

And it won't take the shame away.

All of that belongs to people.

The GP.

The pharmacist.

The family.

Then what's the app for at all?

If four out of five are beyond it?

Because it does the one thing that ties all five together.

It turns a quiet, I didn't take it, into a list you can see.

And once something's visible, you can talk about it.

A mum who hides the blister pack in a drawer is alone with that decision.

A mum whose list is on the GP's desk isn't alone anymore.

OK.

That does sound honest.

Every app pretends to solve everything.

And you're saying outright what this one doesn't solve.

Because if I told you the app would get your mum taking her medicines, I'd be lying to you.

She'll start taking them when she understands what they're for,

stops being frightened,

and stops being ashamed.

And that takes a person.

The app just opens that conversation.

By the way, some of what we've been talking about are actual features of the mojApteczka app.

The list, the report for the GP,

the active ingredient, the counter.

The rest is that conversation they're only meant to make easier.

Just so we're clear, this isn't an advert.

For the record.

You know what?

Now I've got one for you.

About Dad.

About Christoph.

Go on.

Dad takes a blood pressure tablet.

And for six months he'd been taking half the dose.

Halved it himself.

Because he felt fine.

Nobody knew.

I didn't know.

And how did it come out?

It only came out when I started putting his medicines into the app to make that list for the GP.

I look.

It says,

One tablet in the morning.

And he goes,

Well, no.

I take half.

And only then did it come out.

Not through a row.

Through a list.

And that's the whole point.

Not to catch him out.

Not to have a row about,

Why aren't you taking it?

Just to notice,

while entering the medicines,

that what Dad says doesn't match what the GP prescribed.

And take that to the GP.

Because maybe,

after talking it through,

the GP changes the prescription.

Or maybe they say,

he needs to go back to what was prescribed.

That's not something we settle at the kitchen table.

And not something the app settles.

Not the app either.

All it did was show there was something worth talking about.

If you'd like to try the mojApteczka app,

the app is free and works offline.

You'll find the link in the episode description.

And if this episode's been useful,

do send it to someone who's wondering why their mum or dad

won't take those tablets.

One more thing before we go.

This podcast is made with the help of artificial intelligence.

I wrote the dialogue myself,

but the voices you're hearing aren't ours.

They're AI-generated, synthetic voices.

We're telling you this,

straight out,

because we think it should be the standard,

for any podcast made this way.

Full details are in the show notes

and in every episode description.

Until next time.

Until next time.