When 'take as directed' poses a challenge

Given that the average adult over age 55 juggles six to eight medications daily, the ability to consolidate pill-popping is no minor matter. "I'm more likely to be able to sustain a medication regimen if I only have to take it three or four times a day," said Michael Wolf, an associate professor of medicine at Northwestern University who studies drug safety. "Seven or eight times a day is complicated to fit into your daily schedule." His sister, who has lupus, sometimes takes up to 16 different drugs, he noted. "Why can't we standardize prescriptions?" Why indeed? The idea has been kicked around for years. Nearly three years ago, the Institute of Medicine proposed that pharmaceutical manufacturers adopt a universal dosing schedule that would make it possible for people to take medications at just four times of day: morning, noon, evening and bedtime. Virtually all drugs could be formulated to fit into this framework, Dr. Wolf said: "It's ridiculously simple, an incredibly basic idea."