Better Than DrugsWednesday, October 17, 2018
A study published in The New England Journal of Medicine and presented at the American Heart Association’s 2011 Scientific Sessions compared results of patients given free medications after a heart attack with patients who had to make a co-payment for their drugs.
The study left many cardiologists scratching their heads about why only a third to half of patients took their medications after a heart attack even when they were free.
Lost in translation was the fact that there were no statistically significant benefits in reduced major cardiac events for those who did take their free medications.
Be Responsible…Especially After a Heart Attack (Duh…)
Now before this is interpreted to mean you shouldn’t take your meds after a heart attack, let’s observe the usual precautions (follow your doctor’s recommendations).
Most medications work best for those with advanced disease – like those who’ve experienced a heart attack observed in this study.
But that doesn’t mean they work all that well – just better than they do when prescribed for prevention of a first-time event – meaning for those who haven’t had a heart attack or comparable event or otherwise have an advanced medical condition like heart failure or type 2 diabetes.
The relevant conclusion here is that medications are only modestly effective even when taken under ideal circumstances like heart attack survivors immediately after a heart attack. Yet many patients who would benefit with such a medication regimen stop taking their medications and resume the unhealthful behaviors that caused their heart attacks.
So the “Duh” may seem unnecessary, but for too many it applies in spades.
The bigger question, of course, is whether the fascination of American doctors with prescription drugs is justified. Various studies document that American doctors prescribe medications – especially multi-drug “polypharmacy” regimens – at rates ranging from 50% to several hundred percent higher than their physician counterparts in other developed countries (see Our Healthcare Sucks).
Maybe this apparent over-reliance on medications would be acceptable if there weren’t better options available. But there are.
And guess what they are.
Lifestyle, Lifestyle, Lifestyle
Yes, it’s true. It’s even been proven in a randomly-controlled trial used in clinical studies – one of which found that lifestyle modifications were almost twice as effective for preventing complications of diabetes as the leading anti-diabetes medication (see MedSmart Living).
Of course, we all know what the “but” is here…
Few people have the necessary motivation to exercise more and eat better, so doctors often don’t even bother to mention lifestyle changes to their at-risk patients (again, see MedSmart Living).
And doctors aren’t organized in ways that encourage such lifestyle changes for their highest-risk patients. Numerous studies show that outreach by nurses and other “physician extenders” improve patient compliance across a range of behaviors.
But that’s not been a big priority for doctors to date.
They instead continue to focus on why patients don’t comply with their medication regimens – when the better question might be whether better options exist with non-medication lifestyle approaches and how these can best be advanced.
Maybe we’ll get to that point someday.
But the real question is – given the evidence and the desperate need for better solutions to our chronic disease epidemics – why aren’t we there already?
If motivation is a problem for you or a loved one, check out our free report – “CREATING Motivation”.
This article is provided for educational and informational purposes only.
It does not constitute medical advice, and should not be construed as such.
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OR maybe you’re ready to buckle down and read the full book. If so, here’s your chance…