Why is it so gosh darn hard to remember to take a pill?

When you see a health care provider, a vitamin or medicine is sometimes recommended or prescribed. Even if you buy the pill and you want to follow the medical advice, you may find it hard to remember to take it everyday.

For example during annual physicals, I often advise daily vitamin D supplementation. Most of the time patients are highly motivated to start taking the supplement. After all, the time and money required for this healthy behavior is not very high. However, many struggle to remember to take vitamin D regularly and are low again at their next physicals. Why is this?

In my experience with thousands of patients in both Canada and the US, there are several common reasons:

1. Lack of accountability
   Patients may have put off buying the vitamin D supplement, thinking they would do it later. But life is busy and before they know it, vitamin D supplementation falls off their radar. Accountability isn’t often built in - a work boss certainly isn’t going to be asking them if they took their vitamin D and there may not be a follow-up blood test scheduled. However, if their home boss is aware of the deficiency and on the case, they are MUCH more likely to remember to take it.

2. Lack of visibility
   They originally bought the vitamin D and had it in a visible location and were taking it properly. But then ‘someone’ moves the vitamin D into a drawer. It’s out of sight and mind and may not be rediscovered until past the expiration date or after their next doctor visit.

   Or they may buy the vitamin D and leave it in a hidden place such as a kitchen cabinet or a drawer. The principle of ‘out of sight, out of mind’ now fully applies. They may or may not come across the vitamin D tablets now and then, but if the pills aren’t associated with a visual cue, they are forgotten.

   Or they may travel a lot for work and/or pleasure and forget to take it with them or just don’t have the same routine while traveling. For example at home the bottle is next to their toothbrush and they remember to take it every morning or evening. But when they travel, it remains in their toiletry bag or carry on and they simple don’t have the visual cue to take it everyday. A varied routine can ruin a lot of plans mainly because the visual cue is missing.

3. Lack of follow-up
   They may do really well with the first bottle. It’s in a good place and it reminds them to take it everyday but then eventually they run out. They keep telling themselves that they need to buy more but the motivation level isn’t as high as it was when they were staring at their low value on paper or a computer screen. Someone throws out the empty bottle and before they know it, it’s like the supplement never existed. Again, not acting immediately and lacking a visual cue leads to this habit coming undone. Not having follow-up blood tests until the next physical also contributes to falling out of a habit.

4. Too complicated
   They wait for the perfect time. For example vitamin D should be taken with the biggest meal of the day (usually dinner) to be best absorbed. But because of this rule, they forget to take your vitamin D because it’s visible on the dining table. Remember that it’s better to take a medicine in a less than pefect way when the alternative is forgetting to take it. (The one caveat is that some medicines, such as thyroid medication or some diabetes medications absolutely have to be taken in a certain way, so check with your doctor).

If you want to remember to take a vitamin or prescription pill everyday is to link it to one of three things - a time, a place or a previous action.

A fixed time.
For example you will always take it at 7 am - you set an alarm and you have easy access to the bottle either because you are in the same location or you’re carrying it in a bag or purse. This method works best for people who have fixed routines.

A fixed place

You always keep it on your nightstand, where you see it everyday. When you put your glass of water next to it in the night, you automatically take it. Again, this works better when you have the same daily routine. This may not work for people who are traveling often.

A preceding action

You link it up with brushing your teeth, even when you travel. The moment you finish brushing your teeth you immediately take the vitamin. I know of patients who rubber band a small medicine bottle to their toothbrushes to help them remember.

In terms of avoiding running out, planning ahead is key to avoiding disruptions or even falling out of a habit. It’s important to set an alarm for about a week before you anticipate running out. Or you can immediately add it to your to buy list when you find you’re running low. Better yet put it on a timed delivery service so that a new bottle is automatically sent to you prior to running out. Amazon is just one example of a store/site that offers this ‘automatic delivery’.