Take Your Blog Reader To Work Day
The original idea was that the Heck Of A Guy Blog would be my hobby blog, one of those once in a while, whenever I’m in a writin’ mood sort of thing. My real blog would be on my business web site, AlignMap.com, that focuses on patient noncompliance with treatment plans.
It turns out that writing portentous, grandiloquent essays about medical compliance is fun but not as much fun as writing about, well, me. Consequently, I’ve allowed AlignMap.com to languish to the point that I’ve got these two very nice university professors who are, in the gentlest, most polite way possible, on my back to complete some AlignMap documentation that I had hoped to finish last month.
All this is to say that I may have to revert to the original plan, at least for a bit, so entries here at the Heck Of A Guy Blog may not occur every day while I’m catching up at the AlignMap Web Site.
I also want to use this opportunity to give you a taste of what I do on the AlignMap Web Site. Below you’ll find an introduction to patient noncompliance which is, if I say so myself, is pretty interesting, with a link to further information at AlignMap.com. In any case, the issue of patient noncompliance is incredibly important, and you owe it to yourself to familiarize yourself with the concept.
Finally, sometime in the next few days, I’ll let you know about a particularly vicious cycle caused by inadequate patient-physician communication vis-à-vis noncompliance and offer some free advice, guaranteed to be worth the price, about how to protect yourself from falling prey to this potentially expensive and health-endangering trap.
[Update: How To (Correctly) Not Take Medications As Prescribed]
That sounds like fun, doesn’t it? Look, it’s either this or you can go to Study Hall.
The Epidemic
This is a medical problem that has devastating consequences: healthcare costs of $170 billion a year in the US alone (over 10% of this country’s total healthcare costs), enough hospitalizations to account for 10-25% of hospital and nursing home admissions, and 340 deaths per day. It is extraordinarily prevalent, occurring in 50% of the at-risk population, irrespective of socioeconomic class, age, or race.
And it is neither new nor obscure; Hippocrates warned his fellow physicians about it 2400 years ago, it has been the subject of numerous books and hundreds if not thousands of articles in the medical literature, pharmaceutical companies fashion medications in almost every treatment category to address it, proprietary and nonprofit healthcare organizations develop management programs to prevent it, governmental agencies develop policies dealing with it, entrepreneurs sell all manner of devices to combat it, and it has begun to appear in consumer-directed medication advertisements.
Yet, no celebrity lends his name to fund-raising telethons to combat this disorder, no political leader has issued a declaration of war on it, and no prominent self-help group or 12-Step Program has been organized to support the goal of surviving this condition.
There is, in fact, little consensus about its causes, its definition, or even its name. Most significantly, treatment for this affliction, when it has been attempted at all, has been sporadic, inconsistent, and rarely successful.
This mysterious disorder is medical noncompliance – officially defined as the difference between the healthcare provider’s recommended treatment and the patient’s actual behavior (e.g., taking less medication or more medication than prescribed, not following a diabetic diet, failure to obtain indicated immunizations).
Noncompliance can be straightforward. If, for example, a doctor writes a prescription for an antibiotic to be taken twice a day for seven days, but the patient takes only one pill once a day for three days, most of us would agree that this would be an instance of noncompliance.
Beyond that kind of simplistic example, however, the concept of medical compliance becomes complex, confusing, and controversial. In fact, even this example may not be so simple. Is this noncompliant behavior if the patient misheard the physician’s directions? Is this noncompliant behavior if the physician misspoke while giving the directions? Did the patient recall that last time this same medication at full strength made him too drowsy to work? Is noncompliance the same if the patient nine months old, nine years old, ninety-nine years old? Is it actually noncompliance if the patient discovers that the physician misdiagnosed the case or prescribed the wrong medication?
Not only can Patient Noncompliance be confusing but many of the beliefs routinely held by clinicians and laymen are erroneous.
The Patient Noncompliance Myths
After 20 years of talking about patient compliance with clinicians and civilians, I can report with confidence that the prevailing beliefs about treatment adherence are reasonable, based on common sense, and steadfastly maintained in the face of well documented evidence to the contrary. As H.L. Mencken put it,
Click on this link to read about ~Patient Noncompliance Myths~ at the AlignMap Web Site.
Okay I read the web site. I got to the end and it felt like another cliff hanger. Because it sure doesn’t feel like you’re finished ’splaining stuff. I probably missed something. I hate that. I’ll read it again. Sheesh.
Comment by Mrs. Linklater — May 5, 2006 @ 9:40 pm