A
4 - Thomasville Times - Tuesday, June 15, 2010
HEALTH
Stopping or not
filling a prescription
is a bad idea
VIEWPOINT
XXXX
Syndicated Columnist
Almost daily, I confront
patients who elect to stop
or not fill a recommend
ed prescription. In the
field of geriatrics, this
is rarely life-threatening
as the most frequently
prescribed medications
are those used to treat
chronic conditions, such
as osteoarthritis, back
pain, high blood pres
sure, elevated cholesterol
and depression. While
rioncompliance may not
contribute to mortal
ity rates, it seriously
affects a physician’s
ability to maintain
healthy patients.
Research clearly shows
that continued compli
ance with a medical
regimen is frequently
a problem. Nearly half
of patients elect to
discontinue an effective
medication, fail to fol
low the doctor’s advice,
and either stop early
or take their medica
tions incorrectly. Many
patients simply forget
to take their medicine.
Information just
published in the Jour
nal of General Inter
nal Medicine evalu
ated non-adherence to
medications in more
than 75,000 patients
treated by 1,217 medi
cal prescribers. Only 78
percent of the nearly
200,000 prescriptions
were filled, and of those
prescriptions written for
new medications, only
72 percent were filled.
The study also found
that compliance rates
vary with the type of
physicians who pre
scribe medication. For
example, prescriptions
were filled more of
ten when written by a
primary care physician,
particialarly pediatri
cians. Fewer prescrip
tions were fiUed if the
physician was a special
ist, younger, female or
part of a group of more
than 10 physicians.
Prescriptions for
patients under the age
of 18 were more likely to
be filled. Sadly, compli
ance was least likely
in older patients with
multiple chronic dis
eases, including high
blood pressure (28.4 ''
percent), elevated choles
terol (28.2 percent) and
diabetes (31.4 percent).
Patients fail to follow
a doctor’s orders for
various reasons. In many
cases, cost is a con
cern. Patients without
health insurance and
those insured patients
with high co-pays or
deductibles may never
fill a prescription.
For many Medicare
patients, medications
are discontinued upon
reaching the “doughnut
hole” - when insurance
requires the patient to
pay aU costs up to $2,500.
Fortunately, health
care reform wfil slowly
eliminate this gap in
coverage. The cost of
medication is particular
ly problematic for older
adults with multiple
chronic illnesses and
those on fixed incomes.
However, cost is only
one reason for poor pre
scription compliance. Po
tential side effects scare
many patients from
beginning a therapy. In
addition, filling prescrip
tions seems to be partly
assisted by the ease
with which they can be
obtained. For example,
compliance appears to be
higher at Kaiser Per-
manente hospitals and
clinics, where patients
can pick up drugs at
a pharmacy on site.
The key to improving
compliance is education.
Patients must under
stand the purpose of
every prescribed medica
tion. More importantly,
they must know how
benefits of the drug
outweigh potential risks.
Your doctor has an im
portant role in explain
ing the value and need
for a particular medi
cation and providing
understandable informa
tion on the prevalence of
side effects. For virtually
every medication used
to treat chronic iUnesses
such as pain, high blood
pressure, heart disease
and osteoporosis, the
true incidence of side ef
fects is quite rare. Never
theless, when side effects
do occur, particularly if
unexpected, they cause
a great deal of alarm.
I always advise my
patients to discuss
their medications with ‘
a trusted pharmacist,
who plays a key role in
education and minimizes
the risks of side effects.
Failure to take medica
tions appropriately can
lead to continued symp
toms and progressive
disease. Moreover, it con
tributes to poor health
and rising medical costs.
If possible, always
talk to your physician or
pharmacist before dis
continuing a medication.
Whatever the reason
for noncompliance, you
should not feel reluctant
or embarrassed to teU
your doctor that you
have elected not to fill or
continue taking a medi
cation. If cost is a con
cern, discuss it immedi
ately. Generic, low-cost
medication may be avail
able or different thera
pies may be appropriate.
If side effects are
unbearable, do not wait
for several months to
discuss it with your
doctor. CaU the clinic,
make the doctor aware
of the problem and find
out whether there is an
appropriate alternative.
Dr. David Lipschitz is
the author of the books,
“Breaking the Rules of
Aging”and “Dr. David’s
First Health Book of
More Not Less. ” To
find out more about Dr.
David Lipschitz and read
features by other Cre
ators Syndicate writers
and cartoonists, visit the
Creators Syndicate Web
page at www.creators.
com. More information
is available at www.
DrDavidHealth. com.
HPRH to host Teens in Health Expo
High Point Regional Health
TIMES Staff Report
System’s Promoting the
Advancement of Teens in
Health care (PATH) Service
Expo introduces students to
numerous health care oppor
tunities.
Several health system de
partments set up stations,
exhibits, storyboards and
bring “hands on” equipment
in order to share information
about health careers with the
PATH students on Thursday,
June 24 at 9 a.m. at High Point
Regional Hospital
Volunteering not only pro
motes service consciousness
in the community, but the stu
dent cultivates a sense of self
worth. Students see what it is
like to be in a real work envi
ronment. In addition, volun
teering teaches workplace
skills and provides teens with
resources and references for
future employment.
The expo will be held in con
ference rooms Al, A2 and Bl.
The hospital is located at 601
North Ehn St. m High Point.
For more information, call
Jennifer Shaw (336) 878-6000
ext. 2807.
HPRH employee named examiner
for N.C. awards program
TIMES Staff Report
Sue Cumpston, business intelligence ana
lyst at High Point Regional Health System,
was selected and completed training to
serve as an examiner for the North Caroli
na Awards for Excellence (NCAfE) process.
NCAfE is a cooperative industry, academ
ic and government initiative to improve
organizational competitiveness and to
provide recognition for participation. The
NCAfE process provides expert feedback
to organizations on their accomplishments
based upon the prestigious Malcolm Bald-
rige Criteria for Performance Excellence.
These Performance Excellence Criteria
are designed to help organizations enhance
their effectiveness and competitiveness.
www.tvilletinies.com