LifeCare Chiropractic

The Best Chiropractic Care in Mesa, Arizona

compliance

How Compliant are You with Your Heart Meds?

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Let’s face it.  The general public sucks at taking their meds the way they are supposed to.  But it’s still going to help, right?

Studies have shown that upwards of 75% of patients taking medications are not fully compliant.  In other words, the vast majority of medicated patients do not take drugs as prescribed.

With this in mind, understand that trials on medications are done under Ivory Tower-like conditions.  And the results on trials for a large chunk of available medications show a paltry benefit at best (anti-depressants, high blood medications and cholesterol medications are just a few examples).  We can extrapolate that, if the benefits of drugs like those mentioned above are a  hair above non-existent with high compliance, that with low compliance the chance that benefits of the drug will outshine side effects becomes akin to finding the winning Powerball ticket walking through a parking lot.

Just in case you think I’m being dramatic (ok…so maybe the Powerball comment was a wee bit dramatic–but not by much), I present this particular study.  In it, researchers looked at several different drugs, the statins or blood pressure medications (beta-blocker, ACE inhibitor or ARB), to see what the benefits of the drugs looked like if someone was compliant versus non-complaint.   High compliance was considered to be someone taking his or her drug at least 80% of the time they were supposed to be.  Here’s what they found:

  1. Highly compliant patients were 19-36% less likely to have a heart attack or need a heart stent procedure.
  2. Everyone else who did not take the meds as prescribed basically had no benefit.
  3. Even those who were partially adherent had no reduction in heart attacks or cardiac procedures.

This means that, with statins (my favorite class of drugs) or the most commonly used blood pressure medications, only a small percentage of those patients taking them will ever see a benefit.  Even if they do see a benefit, many times that benefit is small.  None of this takes into account the long list of side effects from these classes of drugs.

THIS is what we call “medicine” today.

 

POWERHOUSE DIET ROCKS AGAIN FOR SEIZURES

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So we’ve talked several times about the ketogenic diet and how incredibly effective it is at controlled seizures.  The numbers are very consistent in study after study and, quite frankly, are amazing.

So amazing, in fact, that I remain stumped as to why this isn’t the FIRST path of treatment rather than the absolute last.  The ketogenic diet is almost always used in refractory seizures, which means that the diet is not used until a vast array of medications have been used and have failed.

The ketogenic diet is similar to the Atkins’ diet, in that it is very high in proteins and fat.  The argument against the ketogenic diet is that it is hard to remain compliant with, because apparently having your brain damaged by aberrant firing of neurons is not as important as that slice of bread.

However, recent studies have shown that the modified ketogenic diet, which allows a slightly higher percentage of carbohydrates, is just as effective.  This particular study looks at the compliance argument and pretty much bashes it to shreds.

In a long term follow up study of the ketogenic diet in children over 20 years, 65% of the patients remained on the diet.  I can tell you that, in terms of medication, to get 64% of patients to be compliant with taking a medication for TWENTY years is practically unheard of.

Further,  20% became seizure free and 36% had a 75–99% decrease in seizures. Overall, 56% of the patients had a seizure reduction of more than 75%.  Holy cow! 

So what happened to those who didn’t continue the diet?  Twenty patients who had become seizure free discontinued the diet, but seizures recurred in five (25%). Of 40 patients with a seizure reduction of more than 50% who discontinued the diet, only 25% presented with recurrent seizures.  This means that there was a clear, long lasting benefit to seizure reduction just from being on the diet.

So again, I ask the question about why we use this diet only in refractory seizures.  It is exceedingly powerful.  Patients who follow the diet are very likely to stay on it long term.  AND, it seems to positively change the long term likelihood of having a seizure even in those who discontinue the diet.