January 19, 2016

Other Reasons for Drug Non Adherence

When I wrote this blog on November 6, 2015, I used the reasons promoted by the American Medical Association (AMA) and they are valid reasons. Now I will list more reasons that I feel most doctors refuse to consider.

These are the reasons I feel should be considered:
Communication improves health outcomes. My blog here helps explain this and would reduce drug non-adherence greatly. Without communication, patients may not understand what the medication is for and do not know what side effects may happen and this will increase non-adherence.

Not understanding patient's finances. This is often not a consideration for doctors and they prescribe the more expensive drugs rather than generics. Yes, this can be like cost in the previous blog, but I want to emphasize that too often doctors only care that their bill is paid and too often prescribe an expensive drug they can receive incentives for prescribing.

Patients looking for natural treatments. This is the bane for all doctors, but they need to understand these people. They do not care how large the fistful of prescriptions might be. They just accept them and as soon as they are out of the office, they stuff them in a pocket or purse and they are off to visit the nearest health store to ask questions and see what the salesperson recommends. Or, they are looking for something a friend or relative recommended.

Patients looking for a quick fix and get out the door. These patients think that a doctor is like an auto mechanic. A little bottle of medicine here, and a shot there, and they will be as good as new. Even many patients with diabetes do this and feel that this is the twenty-first century and there has to be a cure. Some even accuse their doctor of hiding this from them.

Patients that have a symptom for everything. They will not let the doctor go until they have explained the symptom (most of the time may be non-existent) and try to convince the doctor to investigate by doing this or that test. These patients can easily be classed as hypochondriacs. They are the dread of every doctor. When the doctor suspicions that they don't have the symptom, they often accuse the doctor of not staying current in his education and become belligerent.

There could be many more, but these and the prior blog cover many reasons for patient non-adherence. Some are definitely the fault of doctors and others are the fault of the patient. I will always blame lack of communication the chief culprit and doctors do not like this. I have asked a doctor for a generic and was told that the generic was inferior in quality. As I was leaving, I quipped that he would not receive money for the generic. I received no answer and talked to the pharmacist who called and was told that he had prescribe the brand name for a reason.

She then said he will not let me fill the prescription. I told the pharmacist that I would see another doctor and see if he would prescribe the generic. She suggested two doctors and when I said one of them, she called to see if he would be able to see me the next day. When she had the appointment, she told the doctor I was taking a medication and gave him the brand name and the generic name. She gave me the office number, location, time and generic name and said he would give me the generic medicine.

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