One in Four Don’t Take Their Blood Pressure Medications


A study in the journal called Heart found that urine testing of patients with hypertension revealed that 25% were partially or totally nonadherent to treatment.  Wow.  How did they find this number?  Well, they used a urine test available to commercial labs and  tested 208 patients for 40 of the most common antihypertensive medications and their metabolites by performing high-performance liquid chromatography–tandem mass spectrometry of spot urine samples.  So, once again, another study shows that at least 25% patients can be noncompliant.  This is pretty consistent with others studies on the matter.   So now what?  Will there be a future where patients get blood work to see if they are taking their meds?  Will we be firing those who fail that test?  It is highly possible.  I can see a time where docs, so blinded by the pay-for-performance numbers and quality indicators, fall victim to their hospital/insurance employers and start culling the herd of these noncompliant patients.

Douglas Farrago MD

Douglas Farrago MD is a full-time practicing family doc in Forest, Va. He started Forest Direct Primary Care where he takes no insurance and bills patients a monthly fee. He is board certified in the specialty of Family Practice. He is the inventor of a product called the Knee Saver which is currently in the Baseball Hall of Fame. The Knee Saver and its knock-offs are worn by many major league baseball catchers. He is also the inventor of the CryoHelmet used by athletes for head injuries as well as migraine sufferers. Dr. Farrago is the author of four books, two of which are the top two most popular DPC books. From 2001 – 2011, Dr. Farrago was the editor and creator of the Placebo Journal which ran for 10 full years. Described as the Mad Magazine for doctors, he and the Placebo Journal were featured in the Washington Post, US News and World Report, the AP, and the NY Times. Dr. Farrago is also the editor of the blog Authentic Medicine which was born out of concern about where the direction of healthcare is heading and the belief that the wrong people are in charge. This blog has been going daily for more than 15 years Article about Dr. Farrago in Doximity Email Dr. Farrago – [email protected] 

  3 comments for “One in Four Don’t Take Their Blood Pressure Medications

  1. kurt
    May 14, 2014 at 4:58 pm

    Whad’ya mean? Docs are already looking at requests of people wanting to be patients. If it looks “bad” ie.
    boatload of drugs on a middle aged diabetic person who can’t stay with one doc, no go in my book.

  2. Pat
    May 14, 2014 at 2:05 am

    It will be only rational for docs to start culling the herds, but let’s consider the further, proper consequences of collective compassion.

    If I’m an employer obligated to pay for my workers’ health care, then I want to be able to ensure that my investment is being well used. If my employee is driving up my overhead through increased premiums due to his non-compliance, then I’m taking it out of his pay. Likewise, if I’m a taxpayer responsible for the costs of certain segments of the population then I want to know that they are meeting their obligation to comply with their subsidized/free care. Why shouldn’t I try to prevent – well actually, defer – the costs of ICU’s and nursing home beds by forcing the Medicare/Medicaid recipients to take their pills properly?

    If I’m an agent of the federal government – and aren’t we all? – then I want to know that each taxpayer is doing his/her part to reduce costs for the overall population; so I would empower the IRS to penalize any citizen not complying with their evidence-based, performance-paid, Institute of Medicine-sanctioned, AAFP-endorsed treatment as prescribed by their happy, cheerful, PriCare provider.

    How dare we continue to indulge in the arrogance of thinking that a patient’s care is a matter of personal choice, even as we make the funding for that choice a collective responsibility?

    The entire point to this story is that it is no longer just your business whether you are meeting your BP, glucose, lipid, or body mass index goals. Pay-for-performance and quality indicators have been embraced as means toward population control, not individual care. Now put down that doughnut you lazy slob, I can’t afford it.

    • Rolando
      May 15, 2014 at 9:31 pm

      Wow. I guess there is no risk of you ever joining the tea party.

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