Tag: non-compliance

Why patients hate the C-word

~ Carolyn Thomas ~ 11 Comments
by Carolyn Thomas   ♥   @HeartSisters

Way back in 1847, the American Medical Association panel on ethics decreed that “the patient should obey the physician.” 

There may very well be physicians today – in the era of empowered patients and patient-centred care and those darned Medical Googlers – who glance nostalgically backwards at those good old days.

Let’s consider, for example, the simple clinical interaction of prescribing medication.  If you reliably take the daily meds that your doctor has prescribed for your high blood pressure, you’ll feel fine.  But if you stop taking your medication, you’ll still feel fine.  At least, until you suffer a stroke or heart attack or any number of consequences that have been linked to untreated hypertension.

Those who do obediently take their meds are what doctors call “compliant”.  And, oh. Have I mentioned how much many patients like me hate that word? 

Continue reading “Why patients hate the C-word” →

How Minimally Disruptive Medicine is happily disrupting health care

~ Carolyn Thomas ~ 22 Comments

by Carolyn Thomas   ♥   @HeartSisters

I went on an adventure to a magical, faraway place. It was my second visit to the world-famous Mayo Clinic in beautiful downtown Rochester, Minnesota. My first trip there was back in 2008, five months after surviving a misdiagnosed widow-maker heart attack.

I was there that first time because I had applied (and was accepted) to attend the annual WomenHeart Science and Leadership Symposium for Women With Heart Disease at Mayo Clinic – the first Canadian ever invited to attend. This is a training program that arms its graduates with the knowledge, skills and (most of all!) Mayo’s international street cred to help us become community educators for other women when we go back to our hometowns.

Thus, a circle that began with me sitting in that 2008 training audience of 45 women (ages 31-71, all of us heart patients) was completed on my second trip as I became one of the presenters onstage – this time in front of an audience of cardiologists! – at a Mayo Clinic medical conference on Heart Disease in Women (Thank you Drs. Hayes, Mulvagh and Gulati for your persistent invitations!)  But long before I took the stage that weekend, I’d been invited to come to Rochester a day earlier to meet with some pretty amazing Mayo staff. Continue reading “How Minimally Disruptive Medicine is happily disrupting health care” →

“I’m just not a pill person” – and other annoying excuses

~ Carolyn Thomas ~ 20 Comments

drugs hands

by Carolyn Thomas  ♥  @HeartSisters

Dr. Lisa Rosenbaum writes in the New England Journal of Medicine about a friend who is worried about her father since two of his sisters have recently died following strokes.  She asks her friend:

“Is he on aspirin?”

“Oh, heavens, no,” the friend replies. “My parents are totally against taking any medications.”

“But why?”

“They don’t believe in them.”

Curious about what she calls this instinctive non-belief, a commonly observed reluctance to take the medications their physicians recommend (aka non-compliance or the slightly less patronizing non-adherence), Dr. Rosenbaum wanted to understand how patients feel about taking cardiac medications. The consequences of not taking one’s meds can be deadly, yet almost half of all heart patients are famously reluctant to do so.(1)   Dr. Rosenbaum, a cardiologist at Boston’s Brigham and Women’s Hospital, wondered: Are there emotional barriers? Where do they come from? Can we find better ways of increasing medication adherence if we understand these barriers?*

So she interviewed patients who’d had a myocardial infarction (heart attack) – first at the time of the initial cardiac event, and again months later.  Their answers fell into five distinct themes that might be surprising to doctors feeling frustrated by their non-compliant patients. Continue reading ““I’m just not a pill person” – and other annoying excuses” →

Confessions of a non-compliant patient

~ Carolyn Thomas ~ 32 Comments

by Carolyn Thomas  ♥ @HeartSisters

.

Consider this scenario, dear reader:  I’m lying in bed one Sunday evening, settled in to watch 60 Minutes for the next hour. But this Sunday is different from any other Sunday because I’ve had three new things to deal with during the past week that are utterly separate from my laundry list of daily cardiac concerns:

  1. I’ve been having physiotherapy three times a week because I twisted my right knee (same one I had knee surgery on seven years ago).
  2. I’m using a new prescription ointment for a pesky patch of psoriasis on my left elbow.
  3. I’m wearing a brand new acrylic mouth guard to bed every night that my dentist has just made for me to help treat a longstanding jaw alignment problem.

So. Here I am lying in bed that Sunday evening as our story unfolds . . . Continue reading “Confessions of a non-compliant patient” →