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Senior Citizen Health & Medicine
Heart Medications: Skipping Medicines Leads to Heart
Attack in Studies
Study highlights consequences of senior citizens
not taking prescribed drugs
 Sept. 13, 2007 - Several studies in recent years
have found senior citizens frequently skip their prescribed medicine,
especially if it is not covered by Medicare or other insurance. A new
study, one of the first to look at the consequences of not taking
medicine, finds that heart patients who most frequently miss a dose are
more than twice as likely to suffer heart attack, stroke and death.
Just over 8 percent of the 1,015 patients surveyed
said they fail to take their medicine at least 25 percent of the time.
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The findings are important because they pinpoint
the size of the problem, said study co-author Mary Whooley, M.D.,
associate professor of medicine at the University of California at San
Francisco.
“The next step is to figure out how we can change
people’s behavior,” Whooley said. “It is so hard to convince people to
lose weight, exercise and take their medicines as they’re supposed to.
If we could figure out ways to motivate people to change, that would
have tremendous public health consequences.”
Whooley and colleagues asked coronary heart
patients taking part in a national study whether they took their
medications over the past month as prescribed. Then they followed the
patients for almost four years to see who died and who had survived a
heart attack or stroke. The study results appear in the Sept. 10 issue
of the Archives of Internal Medicine.
After the researchers adjusted the numbers to
account for the effects of factors like depression and severity of
illness, those who admitted not taking their medication more than 25
percent of the time were 2.3 times more likely to suffer serious
problems — including death — when compared to the others.
Close to 14 percent of patients who more regularly
took their medications experienced cardiac events, compared with about
23 percent of those who more frequently skipped doses.
“Honestly, it’s not really rocket science,” Whooley
said. “It’s pretty intuitive that if you don’t take your medications,
you won’t do as well.”
Why do patients fail to follow their doctor’s
directions? Samuel Sears, Ph.D., professor of psychology and internal
medicine at East Carolina University, said it is often a matter of
miscommunication between the doctor and the patient.
Most patients do not intend to disobey doctor’s
orders, according to Sears. “I put the onus on our health care system
and the providers to walk in the patient’s moccasins a bit and look at
why they can’t get it done,” he said.
One of his own patients, Sears said, did not follow
instructions regarding diabetes medication. It took some questioning to
reveal that she was afraid of needles.
While it is possible that other factors could
affect the health of those who do not take their medications
consistently, it is still important for doctors to ask a “simple
question” about whether patients follow medication instructions and to
follow up if they don’t, said P. Michael Ho, M.D., staff cardiologist at
Denver VA Medical Center.
Editor's Notes:
Original report by Randy Dotinga, Contributing
Writer
Health Behavior News Service
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