Patients managing their own care

A study says that patients can manage some chronic illnesses. It dangerously suggests that patients adjust their own hypertensive medications:

They ask why the methods patients use to take care of their own diabetes — monitoring blood sugar, injecting insulin, evaluating how well they are doing and adjusting dosage — can’t be expanded to other conditions. In one study they cite, patients with hypertension successfully used home blood pressure monitors and adjusted their medications when they needed to.

Once again, the ivory tower spouts out a study out of touch with the real world. Medications like insulin and hypertensive medications can have dangerous and life-threatening side effects. If a self-treating patient gets hurt by their own doctoring, guess who will be on the hook? A hearty “no thanks” to that malpractice risk.

I wonder what’s the next great idea they’ll come up with:

Update:
Apparently the source mistakenly quoted the study. It is now amended (changed text in bold):

They ask why the methods patients use to take care of their own diabetes — monitoring blood sugar, injecting insulin, evaluating how well they are doing and adjusting dosage — can’t be expanded to other conditions. In one study they cite, patients with hypertension successfully used home monitors to lower their blood pressure and stay on their medications.

Big difference. Home monitoring for medication adherence is fine. Having patients actively manage and change doses of their medications is not.

Comments

Anonymous
But you’re still ignoring the fact that diabetics do this and have done so for a long time. Many of them check their own blood sugar, several times daily, and adjust their insulin accordingly. Most of them do so with their physicians telling them to do it.
What really is the difference if they also do it for hypertension? I mean if a person is able to understand and follow directions what’s the big deal. You take whatever does your Dr. tells you to take, based on what range your BP is. I think when we take 3-4 different BP meds daily that many times some of us may be over medicated. Those days where you are extremely tired after taking them, or when you feel really weak could easily be symptoms of too much medication.
RDoc
Interesting, when a patinet measures his blood pressure at home, does he avoid “white coat syndrome”?
geena
That video was just creepy, right down to the music.
Bleah.
Anonymous
Right. Diabetics monitor their sugar and make adjustments. Sugar generally changes rapidly, when it does not, it usually warrants a trip to the doctor.
BP meds take longer to work. A seriously elevated BP might not respond, but the blessing allowing one to adjust their meds might result in delays in treating urgent or emergent hypertension due to a false sense of security.
Of course, there are those that will say that the doctor should provide parameters that should be followed. I’m sure that those that use home nebulizers are also given parameters, but a recent study showed that home nebulizer use was associated with an increased risk of death, presumably due to a false sense of security. There are also studies showing that the majority of home nebulizer users do not use them as directed.
Unfortunately for hypertension, the first sign that the self-directed dosage change is not working is usually something less reversible than hypoglycemia, e.g. a stroke.
RichMD
Blood Pressure Monitor
Folk mus make sure they get an accurate blood pressure monitor and understand how to use it properly.

Patients managing their own care

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