Tag Archives: prescription drugs

When “nudging” doesn’t work to change patient behaviour

12 Nov

by Carolyn Thomas     @HeartSisters

CAROLYN’S WARNING: this article contains a C-word that drives many chronically ill patients stark raving bonkers. Continue reading only if you can stomach the word “COMPLIANT”

Dr. Aaron E. Carroll wrote a compelling essay in the New York Times recently. (By the way, I’ve often wondered why so many people – mostly men, I’ve observed – insist on formally using a middle initial? Is it to differentiate them from all of the other Dr. Aaron Carrolls out there?)*

Dr. Aaron E. Carroll’s subject has intrigued me ever since 2008 when I was told in the CCU that, from now on, I needed to take this fistful of new cardiac meds – many of them every day for the rest of my natural life. And pesky patients who, for whatever reason, do not follow doctors’ orders represent a perennial frustration in medicine. Sometimes the consequences of not being “compliant” (or “adherent”, the slightly less patronizing term) are brutal, so this decision not to can be deadly serious, accounting for two-thirds of medication-related hospital admissions. And more to the point, it begs the question of how to convince people to do what the doctor says they must (or, as some people – but not me – like to call it: “how to make non-compliant patients compliant”). Continue reading

Pill splitting: which ones are safe to divide?

4 Dec

by Carolyn Thomas    @HeartSisters

Physicians and other prescribers are often frustrated by their non-compliant patients. (Full disclosure: as I’ve written about here and here, even the word non-compliant makes me cranky, as it sounds so much like it has punishment at the end of it). These frustrating patients are generally described as those who are not following doctor’s orders (there’s another patronizing term for you) or more specifically, are not taking the medications prescribed for them.

A Consumer Reports Health prescription drugs survey reported that many people are splitting their pills in half to save money on high-priced prescription drugs. The bad news, however, is that many have also learned to save even more money by taking half-doses every other day. Continue reading

Deprescribing: fewer drugs, better health outcomes?

5 Jul

by Carolyn Thomas    @HeartSisters

We all know about prescribing. It’s what our docs do when they pull out the prescription pad so we can start or keep taking a specific drug for a specific medical reason.

But have you heard about deprescribing?

Basically, deprescribing happens when a health care professional decides to taper or stop recommending one or more prescription drugs for any given patient. The practice is aimed at minimizing what’s known as polypharmacy (that’s when adult patients are taking multiple medications at the same time) while at the same time improving patient outcomes.

What’s the problem with polypharmacy? Plenty, as it turns out.
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When drugs that help turn into drugs that harm

18 May

by Carolyn Thomas    @HeartSisters

nutrient-drug-interactions-2129I’ve been thinking an awful lot about drug safety lately, ever since I’ve been camped out at the hospital bedside of a dear friend.  She’s been hospitalized with a severe drug toxicity reaction to a commonly-prescribed medication she’d been newly taking for the past month. And when I say “severe”, I mean you cannot even imagine the horrific symptoms she has suffered day after day after day, week after week, while the pharmaceutical culprit, excruciatingly slowly, clears her system.
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