OT-This health care problem hits a crossroad of many issues including literacy, language, capacity, attitude, perception, etc. Unfortunately Peter your post was too true. I asked once why someone was not using her meds and she told me it was too cold outside so she didn't use it for a couple of days. It took me a couple of minutes to realize that she was confused by the "external use" label. And it is not only labels, but it can be simple communications. Not that unusual for patients to go home and have a very different idea about the status of his/her problem then the doctor. And hospitals try to tell you not too much for the fear of something legal.
Everyone is too busy, doctors, nurses, pharmacists, up and down the health care chain. Healthcare cost is perceived as too high. Fighting the fire is the game, not preventing the fire. Information is targeted at the wrong level. Like reading a drug label, no fun when all you are trying to find out is how to take the drug and about possible interactions. Then try it as an average 76 years old and it is 10x more difficult. Which group takes the most number of drugs? The elderly of course. How many people out there are on coumadin but take a multi-vitamin with vitamin k? How many people run out of money for drugs and they cut back on price not merit.
I know that even twice a day vs. once a day makes a difference in the real world within certain populations in terms of compliance. So it is cheaper for a generic with 3x per day but what is happening to compliance?
I obviously don't have any answers but this is a systemic problem. And we are pretty far from the answer. Personally I tell my friends the best thing you can do for your parents is to help them get a handle on these health related things. Most people don't know that coumadin was a rat poison but that fact helps them understand why it make sense to pay attention. |
