I am not a medical historian, but I would bet that if you asked one, they would identify the synthesis of Aspirin in 1897 as one of most significant moments in modern medicine. With its pain-relieving, anti-inflammatory and anti-platelet (blood thinning) properties packaged within a single tablet, Aspirin provided a safe, effective and easy treatment for a wide range of illnesses. Even today, it is listed on the World Health Organization’s List of Essential Medicines and is taken daily by millions of people for the prevention of heart attacks and strokes. Its synthesis (and the pharmaceutical revolution it helped to user in) has no doubt helped to increase our lifespan and bring about a higher quality of life.
Today, as the burden of chronic illness continues to increase, we look to modern “Aspirins” (eg. Anti-diabetics, statins), to help patients manage their illnesses and lead healthier and longer lives. However, despite these benefits, up to 50% of patients don’t adhere to their medications. This non-adherence stretches across diseases, from Type II Diabetes right up to high-risk patients with Heart Disease. But what causes this lack of adherence? Dr. Lisa Rosenbaum, a cardiologist and frequent medical contributor to the New York Times, decided to find out. Her interviews with heart attack survivors are chronicled in February’s Medicine and Society in the New England Journal of Medicine (available for free here: http://www.nejm.org/doi/full/10.1056/NEJMms1409015).
What she discovers is above all, a patient’s individual feelings about medication seem to be the best predictors of medication adherence. Patients tend to believe that the negative side effects of their medications far outweigh any potential benefits, regardless of whether or not they experience them. On top of this, having a negative attitude towards something (eg. Medication) tends to increase the chance of us discounting any positive benefits it might have.
These negative biases feed into another major issue; a lack of perceived benefit. For many medications, the effects are impossible to feel directly (you can’t feel how much your cholesterol is dropping), leading many to believe that the medication “does nothing.” Combined with the belief that medications are unnatural and a general desire to come off, rather than stay on them indefinitely, these attitudes and feelings are the main drivers of a patient’s medication adherence.
So what should healthcare providers do? Dr. Rosenbaum suggests that we empathize rather than criticize: “It’s our job to help patients live as long as possible free of complications of cardiovascular disease. Although most patients share that goal, we don’t always see the same pathways to get there. I want to believe that if patients knew what I know, they would take their medicine. What I’ve learned is that if I felt what they feel, I’d understand why they don’t.” At MEMOTEXT, we share Dr. Rosenbaum’s belief. That’s why all our intervention programs are patient first and focused on understanding each how we can help patients challenge these negative feelings and beliefs. Only by doing this can we help to improve adherence and overall quality of life.
Lisa Rosenbaum (@LisaRosenbaum17) (Beyond Belief – How People feel about taking medications for Heart Disease
New England Journal of Medicine 372 (2): 183-7, 2015.
Bill has an extensive background in psychology, mental health and clinical data analytics. He graduated with a B.Sc in Psychology from McMaster University in 2007 and is currently in the final stages of completing his Ph.D in Neuroscience.
He has managed data collection and analysis for industry sponsored clinical trials and large international cohort studies. He has 12 scientific publications covering topics ranging from the psychometric properties of rating scales to the pharmacological treatment of obsessive compulsive disorder.
At MEMOTEXT, Bill develops new data analytic strategies and is responsible for integrating new scientific advances into the MEMOTEXT system.