• Don’t let money rule treatment. Again, ask for your doctor’s help in finding a cheaper solution, says Driban. Some prescriptions are expensive because they’re new: Ask for alternatives.

  • Review your medical records. A 2012 study in the Annals of Internal Medicine of almost 5,400 patients found that 60 to 78 percent of those patients given access to doctors’ notes also increased medication adherence. Researchers speculate that seeing the notes provided a prod.  One patient said, “[Reading the notes] is almost like another person telling you to take your meds.”

Staying Active With Less Pain

In a 2012 study at the University of Ottawa in Canada, researchers divided 222 patients with mild to moderate knee OA into three groups. One group walked three times a week for 30 minutes per stretch at a walking club, directed by exercise therapists. Another group did the same but received more behavioral guidance. For instance, they were encouraged to keep log books and set realistic goals.  The third group walked at home without supervision.

“We found that during the first three months those in the behavior group adhered to the exercise program more than the others,” says lead study author Lucie Brosseau, PhD, professor, School of Rehabilitation Science, University of Ottawa. “But at 18 months, the people at home did better [possibly] because they got used to walking by themselves.” All had less pain, more function and better quality of life.

In a 2012 study at Ohio State University, researchers divided 80 patients with knee OA into two groups. The first group followed a traditional approach, asking patients to walk two times a week at an exercise center, increasing minutes as they could. Researchers offered basic exercise education after each session for 12 weeks.  The second group also walked for 12 weeks but were offered behavioral advice.  For instance, they were educated about pacing, dealing with pain and overcoming barriers.

“The amount of physical activity at both three and 12 months was significantly greater in the behavioral group,” says lead author Brian C. Focht, PhD, associate professor, College of Education and Human Ecology at Ohio State University.  “Those patients were doing 50 to 75 more minutes of exercise a week than those in the traditional group.”

Why? Focht speculates that the behavioral approach helped the patients learn how to exercise wisely and overcome barriers.

Adhering to exercise can be even more difficult than routinely taking medications; exercise is helpful but not instantaneously (although meds sometimes are not either).

“There are effective exercise treatments,” says Focht. “But sometimes they’re difficult because of pain, fatigue and stiffness.”