So, patients may be fooled into thinking that the treatment is somehow worse than the disease.
Also, “for younger populations, there’s literature that suggests they don’t want to admit they have a chronic disease that they have to manage for the rest of their lives,” Tajeu said.
Two experts in cardiovascular care said that doctor-patient communication is key to helping people stay on their prescribed meds.
“Untreated, high blood pressure will lead to heart attacks and strokes,” said Dr. Satjit Bhusri, a cardiologist at Lenox Hill Hospital in New York City. “It is very important to be proactive, preventive and adherent to medications, as prescribed,” he explained.
“Frequent patient-physician conversations, prompting, and reiteration of the disease process is the only way to increase medication adherence and persistence,” according to Bhusri.
Dr. Guy Mintz directs cardiovascular health at Northwell Health’s Sandra Atlas Bass Heart Hospital in Manhasset, N.Y. He agreed that doctors need to explain that high blood pressure medications can have side effects, but on the other hand — much like carbon monoxide — “hypertension is a silent killer and must be effectively treated. Patients need to know that this is a high-stakes endeavor.”
Mintz said that certain steps can help boost adherence. First of all, provide patients with a three-month supply of the drug, so they aren’t always having to run to the pharmacy for a refill.
Also, whenever appropriate, stick to single meds with fewer side effects, such as an ACE inhibitor or angiotensin receptor blocker (ARB) drug. “They are better tolerated and associated with better compliance, especially when compared to diuretics or multiple-dose regimens,” Mintz said.
Finally, “forgetfulness can be improved with once per day medications and the use of a pill box,” he said.
Hearing the patient’s concerns is key, Mintz added.
“Ask the patient what are the obstacles they see with your treatment choice and sit back and listen — that response could be life changing,” he said. “We cannot be pill pushers, the data clearly shows that approach is a failure. Instead, we must be coaches and cheerleaders and all be part of the solution.”