Map of life expectancy at birth from Global Education Project.

Wednesday, September 22, 2010

What is WRONG with you people?

As I have often discussed here, there's no use in advancing medical knowledge and discovering wonderful new drugs and all that stuff if the people won't take the pills and won't otherwise follow all that great advice the doctors give them. Yeah yeah, we've had problems with pills not turning out to be so great after all and sometimes doctors want to do too much, etc. You'll often read that first here . . .

But. Lots of stuff we do know works and is well worth it, but people don't do it anyway. Half the people, in fact, as a rough estimate around which many studies tend to converge in various diseases, don't take their pills the way they are prescribed. So we're always spending money testing "interventions," as we say, to encourage people to follow the advice and take the pills. In heart failure, that's particularly important because, well, it can keep you alive longer.

That's why it's a bummer that once again, a carefully designed and well conducted intervention just didn't work. In this case, people with heart failure got group based education and counseling -- plenty of it, 18 two hour meetings over a year. The control group just got tip sheets. Well, it didn't matter. Didn't do a damn thing. The people who did the group sessions were just as likely to kick the bucket as the ones who didn't. (And props to JAMA for making this open access.)

Sometimes these interventions work for a little while but the effect goes away once they stop. To get people to take their pills the way they're supposed to it seems like about the only thing you can do is have a nurse move in with them.

Listen up folks! It really matters! If you need blood pressure pills, for example, they aren't just a luxury or just a nuisance or some conspiracy by Big Pharma to take your money. They can spare you from heart attacks and strokes and disability and death. It's no joke. Why won't you do it?



Steve said...

Why won't I do it?

Same reason I won't exercise and eat right. The brain has a mind of its own, apparently.

Cervantes said...

Well kick your brain in the ass and start exercising and eating right.