More than half of Americans don't take their prescriptions as directed, despite believing that the medications will help them, a new survey finds.

Of 1,000 adults polled in the study, by Prescription Solutions and the National Council on Patient Information and Education, 54% said they don't consistently take prescriptions as instructed. Yet nearly 60% think that following prescriptions leads to better health and helps lower health costs.

IRVINE, Calif. — More than half of Americans don’t take their prescriptions as directed, despite believing that the medications will help them, a new survey finds.

The study, released this week by pharmacy benefit manager Prescription Solutions, a UnitedHealth Group subsidiary, and the National Council on Patient Information and Education (NCPIE), examined prescription adherence. Of 1,000 U.S. adults polled by telephone, 54% said they don’t consistently take prescriptions as instructed, yet 87% think the medicines are important to their health.

Also underscoring the paradox, nearly 60% of those surveyed said they believe that when people take their prescription medications as directed, it will lead to better health and can help lower costs to the health care system.

When asked why they didn’t follow their doctors’ instructions, 59% said they started to feel better and didn’t think it was necessary to keep taking the medicine. Thirty-seven percent expressed concern about side effects, and 25% said they weren’t feeling any better and decided they didn’t need to keep taking the medication.

Cost was a factor as well, with 24% of those polled indicating that they stopped taking their medicine because it was too expensive.

Respondents also admitted to some transgressions in following their prescriptions. For example, 37% said they didn’t finish taking all the medicine as instructed, and 31% said they skipped doses. Twenty-three percent said they didn’t refill their prescriptions as instructed, while 8% said they took more doses than instructed or doubled up on doses.

When asked what would help them take their prescriptions as instructed, 39% of those surveyed cited refill reminders. Twenty-five percent said they would do better at taking their medication as directed if someone — such as a loved one, a caregiver or a health care provider — could follow up with them or encourage them along the way.

More than a third (34%) indicated that they would adhere better to their prescription regimens if they were provided easier-to-understand instructions. Almost half said lower costs for prescriptions (49%) and fewer side effects (48%) would help them do a better job of taking their medication as instructed.

The study also found that when respondents experienced a side effect from a prescription, 65% said they discussed it with their doctor or pharmacist, with women (72%) more likely to do so than men (57%).

"The hidden health, financial and productivity costs of people not following their medication regimens as instructed are profound, making prescription nonadherence a national health problem," Jacqueline Kosecoff, chief executive officer of Prescription Solutions, said in a statement. "The survey clearly shows that people need and want more information, guidance and help understanding and using prescription medicines."

Prescription Solutions and NCPIE pointed to a recent New England Healthcare Institute study finding that otherwise avoidable medical spending resulting directly from nonadherence to medication accounts for up to $290 billion per year, or 13% of total health care spending.

"Poor medicine adherence — dubbed by NCPIE over two decades ago as ‘America’s other drug problem’ — appears to be as pervasive and costly in terms of health and economic consequences today as in years past," commented Ray Bullman, executive vice president at NCPIE. "These survey findings underscore the challenge of nonadherence and the need for frequent and ongoing communication between consumers and their health care providers about medicines so that consumers recognize the value of medicines properly used and can derive the maximum benefit — and the minimum risk — from their prescription medications."