Do your patients use their blood pressure medications correctly?

A recent analysis of the use of blood pressure medications within the United States Medicare system reveals that 26 per cent either skip doses, or stop taking their drugs entirely, thereby increasing their risk of heart attack and stroke.
Other research within that system shows that up to 25 per cent of new prescriptions for blood pressure medicines are never filled in the first place.

A GP mate of mine admitted recently that CPD seminars on hypertension seem to focus on diet and lifestyle.
She is not comfortable at all within that space.
How comfortable are we?

Do we pharmacists have the courage of our convictions to be more assertive in the treatment and management of our hypertensive patients?

  • Do we discuss the adverse effects with them at the initial supply?
  • Do we address any nutritional deficiencies that might accompany their medication?
  • Do we discuss moderate exercise and sensible food choices as part of their treatment plan?
  • Do we assess how they are feeling, in repeat script instances?

Or do we keep doing it and doing it, potentially contributing to the challenges faced in the United States?

Here’s a few thoughts:

  • Diuretics deplete potassium, magnesium, zinc and B-group vitamins. Some affect serum lipids and blood glucose.
  • Beta blockers cause changes in serum lipid fractions. Some increase the risk for heart failure, cause weight gain, increase risk for diabetes, decrease energy and cause sexual dysfunction. They decrease levels of Coenzyme Q10, thereby reducing the energetics of cardiac cells.
  • Selective alpha blockers cause dry mouth, constipation, sedation and dizziness.
  • Up to 50 per cent of captopril users experience fatigue or lethargy. Many encounter sleep and sexual disorders, nightmares, anxiety, nasal congestion and muscle cramps.

Another recent research release shows that moderate exercise reduces cardiovascular disease risk by over 50 per cent.

It’s time to be a part of what our patients want – and it’s not a pill!

Editor’s footnote: And just as Gerald’s article points out that one component of pharmacist culture is “pushing back”, Seth Godin comes along with a similar view.
He says:

The professional pushes back

The architect refuses to design the big, ugly building that merely maximizes short term revenue. She understands that raising the average is part of her job.

The surgeon refuses to do needless surgery, no matter how much the client insists. He doesn’t confuse his oath with his income.

The marketer won’t help his client produce a spammy campaign filled with tricks and deceptions, because she knows that her career is the sum of her work.

The statesman won’t rush to embrace the bloodlust of the crowd, because statesmen govern in favor of our best instincts, not our worst ones.

There are plenty of people who will pander, race to the bottom and figure out how to, “give the public what it wants.”
But that doesn’t have to be you.
Professionals have standards.
Professionals push back.


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