Compliance

Maybe this would make more sense to the one person who has by chance been a bit unlucky to be with a chronic medical condition. On the other hand, the one who stands on the opposite side might have the best of understandings, the greatest of sympathy yet the least of ability to change.

For the past few months, Thursdays have been the worst of worrisome days in the week for me. Why? Thursday happens to be the clinic day – to see out-patients. I had managed to brush aside all ill-feelings I had carried with me through the morning and made my way to start the clinic.I took to a seat, ensured the air conditioner was working right at the exact 18 degrees Celsius I wished it and requested the patients could be ushered in.

Barely after this woman had left did he enter. With a smile on his face. I greeted him first. One thing I learnt from one of my bosses along the line. I shouldn’t wait for a patient to greet. Just in case they don’t greet, I might get a bit pissed off. So greeting first prevents all that and as well sets me in control of the yet to unfold discussion between us. So I did that. With a good smile he answered and made himself comfortable in the seat to my left. I used that time to glance through his folder, just to have a chance at what he had been managed for and how in his previous visits to the facility. Looking through, one thing struck me.

He was on. Tab Nifidipine, Tab Lisinopril, Tab Aspirin, Tab Artovastatin, Tab Metformin, Tab Glimeperide, Tab Tamsulosin. Maybe there are others I couldn’t commit to memory. So I said with a smile to him, “I can see your drugs have increased in number”. His response got us into an even more intriguing discourse – “oh… don’t worry. Just check it well. It is even off late that the number has reduced. You know the issues of old age.” We shared a laugh, I attended to him, reviewed his medications and bid a bye to him. At the end of the day, one thing kept running through my mind – compliance.

Well, growing up, one of the things I have found very difficult to do is taking oral medications. I know I might not be the only one with such an issue. How I managed to overcome the inability to swallow medications still remains a mystery. Anytime I had to take a tablet, it had to be in a morsel of “fufu” or “banku”. But that method wasn’t going to last. Mum, could not change her menu for the week just because I had to take my medications morning and evening. I know how unpleasant it can be to take medications. But here it is that I find myself amongst the host of people whose obligation has been to use the unpleasant to bring comfort to mankind.

To one end, I feel prescribers are a bit insensitive (I am one too, I am aware). We give clients a whole list of prescription with medications having different dosages, taken at different and odd times.We expect perfect compliance. When they aren’t able to comply, we feel so burdened and disappointed. Out of passion to save their lives, we sometimes take things so personal that we have to scream a bit of scare into clients to get them to comply.

We also do feel the pity. Our clients were at one point in their lives very healthy people, maybe even healthier than we are. But because of some chronic condition, diagnosed suddenly at some unexpected time in their lives, they have to restructure their existence and its style, eating pattern, sleep patterns, their throats in order to have a bettered life expectancy. How uneasy this can be!

The issue of compliance. I don’t think any prescriber would wish, out of true knowledge to overload a client with medications. It would actually be the wish of every such practitioner if non-pharmacological methods alone could be the best means towards achieving the goal of the therapy.

The sour dilemma of what we do. Using the bitter approach we abhor in ourselves to effect comfort in another. How best can we handle this issue of compliance? What if we were to have been on the other end of the prescription?

3 thoughts on “Compliance”

  1. It’s sad prescribers don’t sometimes look beyond the prescription table and sit themselves on the other side of the table.

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