Treatment vs Cure

I am quite sure that I am not the first, last or the only doctor around who often gets very frustrated when they hear their patients saying “…but I felt better so I stopped taking them!”.
Successful treatment of disease with prescription medicines requires consistent use of the medicines as prescribed. Yet research shows that medicines commonly are not used as directed. Non-adherence to medicines is a major health care cost and quality problem, with numerous studies showing high rates of non-adherence directly related to poor clinical outcomes, high health care costs, and lost productivity. The cost of non-adherence in the USA alone, has been estimated at $100 billion to $300 billion annually, including costs from avoidable hospitalizations, nursing home admissions and even premature and theoretically speaking, avoidable deaths.

The difference?? Pure semantics, one may be willing (compliant) to sticking (adhering) to a treatment regime as set out by one’s doctor but the reality is rather different.

World Health Organization reports that only around 50% of people typically follow their doctors’ orders when it comes to taking prescription drugs — and the rates are lower for certain medical conditions. Only 43% of patients take their medicine as prescribed to treat acute asthma. Between 40% and 70% follow the doctor’s orders for depression medication. Just 51% of patients take the prescribed doses of high blood pressure medicine. Quite scary statistics if one considers the following facts that are attributed to non-adherence:

  • 1 out of 8 heart attack patients stops taking life saving drugs after just 1 month
  • 31% of all prescriptions are not filled the first time
  • 15% of all hospital visits ($47 billion/annually) are due to medication non-adherence
  • 125,000 deaths annually are the result of non-adherence
  • Ineffective treatment outcomes
  • Higher healthcare costs
  • Lower employee productivity
  • Stronger/adaptable viruses

The bottom line is that the failure to take drugs on time, in the dosages prescribed and for the length of time prescribed, can be as dangerous and costly to the Health Care System as many of the original illnesses.

Adherence to therapy is especially important for management of chronic diseases, such as diabetes, heart disease and cancer. And yet so many patients end up proverbially shooting themselves in the foot because they fail to grasp the concept of “treatment vs cure”. We can CURE a bacterial infection with a course of antibiotics, but we TREAT chronic conditions such as Diabetes or Hypertension, with a constant dose of appropriate medications. Failure in continued adherence to the treatment plan causes a disruption and eventual total breakdown of our control over the disease. Even Harvard University researchers have recently remarked that poor adherence among patients with chronic conditions persists “…despite conclusive evidence that medication therapy can substantially improve life expectancy and quality of life…”

So the next time your doctor tells you that yes, you do have to take this medication FOR LIFE , maybe there is a reason behind it … and it’s not just their shares in the Pharmaceutical Company that are talking!

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