Barry O’Sullivan and Kate Sullivan are clinical Pharmacists at Mater Private Hospital, Cork.
THE morning alarm sounds and slowly your eyes open to the world after a night’s sleep. You reach out to the bedside locker for the glass of water resting there. Your eyes then see them, lined up, ready for action, a selection of capsules and tablets — your morning medicines. For a moment you stare at them blankly, unsure what they do or how they work, just that you have to take them.
Taking your medications in accordance with the prescribed regimen is called compliance. Following the routine means therapeutic levels of your medicines are in your blood and so can help bring things like blood pressure, cholesterol, and mood into line with targets set for you.
The level of compliance varies with the differing conditions but can be as high as half of a given patient group not following the recommended care pathway. This is a huge problem.
There is a substantial cost to this, both human and financial. Research indicates it costs in the region of €125bn across Europe, with 200,000 people passing away prematurely as a result of medication non-compliance.
Built into this cost are extra medical visits, hospital stays, procedures, and associated investigations that would have been avoided if the prescribed course of medicine was followed.
Not every medicine needs to be taken every day. Some are prescribed in courses, such as antibiotics, while others are only for as-required use, like certain forms of pain relief or anti-anxiety medication; your doctor or pharmacist will flag these for you.
Let’s look at the daily medicines, the ones that need a steady intake to make sure they work. If we take too much we run the risk of toxicity; too little and they won’t work to a therapeutic level. Most people don’t like the idea of being on long-term medications, the idea of being seen as unwell doesn’t sit easily with them. Many factors affect a
patient’s compliance, such as cost and side-effects.
Conditions like high blood cholesterol and moderately high blood pressure generally don’t have any obvious symptoms for the patient — they don’t feel sick so why take the medicine?
For these conditions, it’s all about damage prevention. By keeping parameters under control, the risk of events like a heart attack or stroke is greatly reduced. If your doctor routinely issues you with a prescription for a regular medicine the understanding is that you take it. Building on this, if, say, your blood pressure rises and your doctor reviews the medications, he or she will take it that the current regimen is not working and may increase strengths, add in additional drugs, or refer onwards for investigations.
So what should you do?
If you feel there are too many medicines prescribed to you or that there are medications you don’t need talk to your pharmacist or doctor. Don’t just stop
them without having the discussion.
If the side-effects of a medicine are unpleasant and intolerable speak to your pharmacist or doctor, there may be other options that could suit you better.
Learning about the medicines you take and growing your understanding of them will make it all less daunting and empower you to help become a partner in your own healthcare. Just make sure your information is from a valid source like a healthcare professional, organisations like the HSE, or maker of your medicines.
Each medicine will have a patient information sheet which provides lots of details for you. Please keep in mind, however, that the list of side-effects can often be very long but the first two or three on the list are the most common. The side-effects become less frequently experienced as you move along the list, with the
rarest at the end.
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