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Don't second-guess your prescription
medications
When I say that my wife is noncompliant, I mean that she never
follows the financial advice I so freely give her, "which is
the main reason," she often tells friends, "that my
business is successful." In medicine, however, noncompliant
has a different meaning: it's what we call people who don't take
their medications as prescribed, and according to a study in the
Archives of Internal Medicine, the noncompliant are the majority:
most people, it seems, don't take all the pills prescribed or they
don't take the full dose.
As well, lots of people take drugs that they don't tell their
primary physician about (over-the-counter, herbal, or even
prescription medications prescribed by other doctors), and which
could, of course, react adversely with something their primary
doctor gave them.
The really scary thing to me, though, is that according to a study
published in the journal Chest a similar noncompliance phenomenon
occurs in clinical trials (studies to evaluate a drug, many of
which are done before it's released to see how well it works and
how safe it is). In this study on chronic lung disease, 30% of
subjects didn't take the drug the way they had been told to take
it, and many of them simply "dumped" the contents of
their inhaler just before visiting the researchers to report on
how well they were doing.
So why are people noncompliant? Because they are (legitimately)
concerned with the potential side effects and complications of
medications, fears aggravated by a constant barrage of "bad
news" stories about medications in the media, and by doctors
who often don't take the time to discuss the risks and benefits of
a medication they prescribe. Another factor adding to people's
concerns is that so many new medications have come along that even
doctors are not completely familiar with many of them yet, and
thus often offer conflicting information about them to confused
patients. Finally, the last few years has seen an explosion of
often surprising information to scare us about the hitherto
largely neglected area of drug interactions. I mean who but a
die-hard fruitarian would have ever guessed that grapefruit juice
is powerful enough to affect the blood level of certain
medications?
What does this have to do with you? Only this: if you ever become
unsure about a medication you're on, don't just flush the
remainder of the prescription down the toilet (for a start, who
knows what you might do to the porcelain?) Instead, find out all
you can (from the Internet, pharmacists, doctors, etc.) about the
benefits (all medications have benefits) and risks (ditto!) of
this medication, and discuss your conclusions - can you stop
taking it, can you take a reduced dose, can you use an herbal
product instead, etc. - with your doctor.
Art Hister, MD
in association with the MediResource Clinical Team
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