Every day, we all make choices by weighing the potential benefits of a decision against the potential risks or burdens. It’s a beautiful house, but can I afford it? My job’s O.K., but should I look for a better one? I want to watch the game rather than go to the party, but is it worth upsetting my spouse? And yet when it comes to our health, we routinely fail to accept that the pluses greatly outweigh the minuses for one important choice: taking our prescription medications.
Non-compliance (the failure to take medications as directed or at all) is epidemic. It is estimated that up to one half (one half) of all prescription medications are either not taken correctly or at all. In fact, many of us don’t even fill our prescriptions. After learning from their doctor that they need a drug in order to prevent a future heart attack, stroke, kidney failure, whatever, more than one in five people fail to fill their prescription. One study of over 195,000 e-prescriptions (prescriptions electronically delivered to the drugstore without you having to do anything) revealed that the greatest offenders were patients prescribed new medications for chronic conditions, such as high blood pressure (>28% unfilled) and diabetes (>31% unfilled).
Listen. Not taking prescription medications is far more dangerous than not reading your mortgage contract before signing or buying a used car without first test driving it (neither of which you would do!). Instead of having to work a second job or rebuilding an engine, not correctly taking your meds is far, far more dangerous: medication non-compliance is estimated to cause of 125,000 deaths a year and 10% of all hospitalizations.
If you truly want to see your granddaughter graduate college, if you really want to visit Europe with your wife after you retire, if you must see the Cubs win a World Series…whatever you wish to do years from now, your best shot at getting there includes taking your medications. Every medicine. Every time you’re supposed to. Every day. Don’t own every important major aspect of your life except your health. Own your health!
To own your health you must first honestly analyze your medication non-compliance. Based on my years as a physician partner, I divide non-compliant patients into three major groups. And remember, you may be a member of more than one:
Most of us have seen a news or YouTube® video with a blonde, buffed, smiling surfer showing off the shark-bite-shaped piece missing from his board. Inevitably, the surfer says something like, “Sure, I’m going back in the water. I just love surfing, and this is the shark’s domain, and if I die doin’ what I love…so be it.” There are Shark Surfers in healthcare, too. The guy who says, “I know I have high blood pressure, but I don’t take medicines, and if I die of a heart attack, so be it.” I believe that many if not most medical Shark Surfers do ultimately suffer major, even fatal events as a result of their “things are what they are” philosophy. And by definition, Shark Surfers won’t own their health (it is very, very difficult to keep a surfing fanatic out of the water if he care that he is surfing among sharks).
That said, given that you’re reading this, the odds are extremely low that you’re a Shark Surfer. So read on.
Many, many people who fail to correctly take their medications are Credit Carders. Credit Carders prescribe to the philosophy of “Enjoy Now – Pay Later.” People whose health ailments are “silent” (that is, conditions which don’t produce symptoms) are particularly prone to the Credit Carder approach. Hyperlipidemia (high blood cholesterol) routinely doesn’t cause pain, fatigue, nausea, hair loss, or any symptoms. So why take a statin drug every night? And why take drugs once or twice a day for hypertension, when high blood pressure causes most people no symptoms? And who wants to prick their finger several times daily to check their blood sugar level when diabetes doesn’t hurt?
Here’s the reality: hyperlipidemia doesn’t hurt…until you have a stroke. Hypertension doesn’t hurt…until you have a heart attack. Diabetes doesn’t hurt…until your kidneys fail.
It’s challenging to change your behavior if you’re a Credit Carder whose health problem doesn’t cause symptoms. Just remember, like real credit cards, you always eventually pay. And in this case, you’ll likely pay by forfeiting many of your future plans and dreams and, possibly, your life. Only when you accept true ownership of your health, including the need to routinely and correctly take your medicines, are you giving yourself your best shot to enjoy that future you envision.
Many people, especially older patients and people raised outside of the American culture, were raised to never question their physicians. Others are simply too intimidated or uncomfortable to ask. These people communicate differently (if at all) with their physician than they do with everyone else. When Different Drummers don’t understand why they are being prescribed or how to correctly take a medication, they don’t ask for clarification. When Different Drummers don’t like the way their medicine makes them feel, or when Different Drummers can’t afford their medication, they’re more comfortable risking their health (by not taking their drugs correctly or at all) than they are speaking with their physician about their concerns.
If you’re a Different Drummer who has pain or some other symptom, but you’re not taking your prescribed medication because it makes you feel lousy (sleepy, “cloudy,” nauseated, impotent, whatever), own your health and tell your doctor. Chances are there are other medications that will reduce or resolve your symptoms without making you feel lousy (different drugs for the same condition often have different side-effects). If you’re a Different Drummer who can’t afford your medication (and, therefore, don’t take your pill regularly or at all), own your health and tell your doctor. There are often generic medications to treat your condition that cost much less than the newer medication you’ve been prescribed. And if you really need but can’t afford that new, high cost drug, you have options: a number of drug companies offer financial assistance programs, as do many U.S. states through State Pharmaceutical Assistance Programs. And if you are a Different Drummer who is uncomfortable speaking to or questioning your physician, own your health and get over it! It is your health, your life, and your future. And here’s the truth: most physicians are happy when our patients are engaged in their own care.
The health journey that you take is in large part up to you. When weighing the benefits verse the burdens of owning your health, the scale tips heavily to one side.