Comments on: How To (Correctly) Not Take Medications As Prescribed

By: DrHGuy

DrHGuy — Mon, 03 Jul 2006 11:08:41 +0000

While I realize it’s not your primary point, there is little evidence that appeals to maintain public health have a significant effect on compliance, primarily because folks who care about the good of the community tend to be high on the adherence scales already so such efforts are superflous in their case and have little impact toward those who don’t have similar values.

Related to this issue is the notion of when or if it is justifiable to force treatment on a resistant individual to protect others. You might be interested in today’s entry at AlignMap, my professional blog: Coerced Treatment Of Tuberculosis & HIV

By: Helen

Helen — Mon, 03 Jul 2006 03:18:10 +0000

Disclaimer: I have no medical training, I’m just very opinionated.

As plan C, you could say: “If you fail to take these antibiotics properly thus building bug resistance / refuse to immunise your child against whooping cough thus decreasing herd immunity / etc, you are no better than a fecking murderer.”

By: DermofDuke

DermofDuke — Fri, 30 Jun 2006 12:50:27 +0000

Dear Dr. Hguy,

I know that young doctors and doctors to be all believe that patients essentially never take medication correctly. They believe this to be the case so strongly that very often they fail to consider the fact that their diagnosis and therapy may be wrong.

One of my favorite clinical teaching activities is quizzing residents about why their prescribed treatment is failing. Approximately 99.99999% of the time the answer is ‘the patient is not taking the medicine or performing the prescribed treatment correctly’. Only after some prodding is consideration given to the fact that they may have given the wrong medicine or made the wrong diagnosis.

Second clinical point. Doctors need to ask the patient what medicine they are taking and how are they are taking it. Current trends are to have ‘assistants’ perform this part of the history and then to simply look at the list they generate. This saves time,allows you to see more patients etc. More effecient? Patients, in my experience, are much more reluctant to tell a nurse that they didn’t do what the doctor said than to tell the doctor. We can help by simply asking patients directly, ‘How are you taking that medicine? Are you able to take every dose?’ Many in my experience fess right up.

All totalled if the Doctors ask and the patients tell we will move more quickly to the real issue of why patients aren’t getting better and begin to include the issues of wrong medications and wrong diagnosis at the appropriate time.

That’s my story and I’m sticking to it.

By: MindSpin

MindSpin — Thu, 29 Jun 2006 12:47:34 +0000

Useful post. Interestlngly, I haven’t found my doctors to be averse to this sort of discourse. They know we patients are an obstreperous and occasionally sneaky lot, so most seem to welcome my laying the cards on the table. The dynamics of the conversation change. There’s a better working relationship, and I get better care.