Prescriptions and Chronic Illness

Here's an amazing quote from a clinician, reported in a landmark study on chronic illness at the journal Annals of Family Medicine:

I've got patients on 4 different medications and their blood pressure is still uncontrolled. We try sending them to the cardiologists, and they say, 'Just keep adding stuff because there's really nothing we can do about this.'... Some people whose blood pressure that we get normal again, they don't function very well at all. I'm not sure why."

And then a patient's experience with multiple medications for chronic illness:

Sherie, a 54-year-old African American woman, is a recently unemployed cosmetologist who lost her health insurance several years ago. She has been taking hydrochlorothiazide and a β-blocker for hypertension for 13 years. Two years ago, she started taking metformin and glipizide after a random glucose reading of 130 mg/dL, as a preventive measure, because of a strong family history of diabetes. After her diabetes diagnosis, her doctor used a lower diagnostic threshold for hypertension and for high cholesterol, and she was prescribed a third antihypertensive and a statin.

Sherie is currently taking 8 prescription medications: 3 for hypertension, 2 for diabetes, 1 for high cholesterol levels, and 2 for depression. She has been able to get some of her medications through a county health program that offers generic medications for a $6 copay. But, she explains, even that reduced amount is difficult for her: “I used to take my blood pressure pills every other day because every time I turned around I was buying more. And $6 seems like it’s not a lot, but it is when you ain’t got it.” She has recently started receiving 3 medications (Norvasc, Lipitor, and Zoloft) through the Pfi zer patient assistance program, but she continues to struggle and is now coping with serious adverse effects.

Her diabetes medications cause diarrhea and bouts of hypoglycemia, which interferes with her ability to leave her home because she must eat and go to the bathroom so frequently. She also had 5 visits to the emergency department in 1 month for excruciating headaches, before they were determined to be an adverse effect of the additional hypertension medication she had been prescribed after her diabetes diagnosis. She was able to change hypertension medication with the help of the Pfi zer program. At her most recent appointment, her physician happily told her: “Your blood pressure is 130/78 [mm Hg], your A1c is 7.0[%], and your cholesterol was normal. Very good!”

Read the whole thing.

It is becoming more apparent that prescription medications are excellent and often essential in emergency and urgent situations, but they may not be the answer for long-term or preventative care. The authors of the article delve into the reasons why, ponder the nature of side effects, discuss the real and artificial reasons why so many more people are being diagnosed with chronic illness, and more. They conducted this study and wrote this article with the goal of improving outcomes in patients with chronic illness. If you or a loved one has a chronic illness such as hypertension, prehypertension, high cholesterol, or diabetes, you'll need to read this study.

H/T Dynamic Chiropractic