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When you don't do what the doctor says - (6/16/2020)

By Dr. Ron Gasbarro

Round one: The argument started the second Mr. McQuarrelson walked through the front door. “My doctor said my blood pressure is up,” McQuarrelson said to his wife. “Did he ask you if you have been taking your blood pressure pills?” his wife asked. “Yes,” he replied. “And have you?” “Well, no,” he admitted. “I stopped taking them a few months ago.” “Are you trying out for Idiot of the Year?” his wife exclaimed. “Don’t you know that hypertension can cause a heart attack or stroke?” “Yeah, well, kind of,” he muttered. “Anyway, the pills are too expensive.” “You mean it’s better to save a 30 dollar co-pay than to keep yourself from getting a stroke?” Mrs. McQuarrelson yelled. “You spend more than that on lottery tickets and beer a week! Talk about selfish! Do you think I want to feed you and change your diapers after you are too sick to move?”

Round two: Mr. McQuarrelson cracks open a beer and hopes his wife stops screeching. Wrong! “When were you in the pharmacy last?” she hollered. “When I bought you that beautiful birthday card!” he countered. "Yes, the one that was two days late. Did the pharmacist say anything to you?” “He said that my pills were ready to be refilled,” he responded. “And you said…?” Mrs. McQuarrelson asked, using her spatula as a pointer. “I said I would be back in a few days.” “And you never returned, did you?” “I’ve been busy,” he said, as he noticed his shoes needed a good buffing. 

A recent study published in the Annals of Internal Medicine reports of an “out of control” epidemic in the US that costs more and impacts more Americans than most other diseases we experience. Moreover, it is 100% preventable. Medication non-adherence causes approximately 125,000 deaths, 10% of hospitalizations, and costs the already burgeoning healthcare system up to $289 billion a year. Research shows that the higher one's blood pressure is and the more conditions one develops over the years, such as diabetes and arthritis, the more likely one is to have a significant cardiovascular event like heart attack and stroke. If a person is in the habit of skipping the pills that his prescriber has determined he needs to live, the lower his chances are of seeing his kids graduate from college.  

Children are not responsible for remembering to take the medications that are prescribed for them. That is what Mommy and Daddy are for. But Mr. McQuarrelson is 52 years old and should know better. How selfish he was to neglect the medications that allowed him to keep working and supporting his three kids and wife. How mindless of him to expect them to drop their lives, careers, and relationships to tend to him when he is incapacitated. Think of the medical bills that can pile up. Their entire quality of life can go down the hopper because he is not taking his pills. Is he waiting to win the lottery? Grow up!

Round three: “OK, this is how this is going to play out,” Mrs. McQuarrelson announced. "I am getting you a daily pillbox. I will watch you fill the box with your bills for the following week. I will check every day to see if you took a pill. I will call the pharmacy and have you put on auto-refill that will alert you to pick up your medicine. I will have to treat you like a child. I married an equal. I expect you to act like an equal. Our family and way of life depend on this one little thing! If you do not take this seriously, you can take your stroke, your beer, and your lottery and live at the YMCA!” 

“Well, that was a knock-out punch!” said Mr. McQuarrelson, now terrified. And with that, he swore to act responsibly under penalty of death in so many ways.

Ron Gasbarro, PharmD, is a registered pharmacist, medical writer, and principal at Rx-Press.  


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