Doctor-patient communication is important in improving heart health
HOUSTON, Texas — When it comes to matters of the heart, communication is key, especially between a patient and a doctor. Cardiologists at Baylor College of Medicine say your heart health could be improved by talking to your doctor about risks, prevention, treatments and even difficulty with medications.
Dr. Salim S. Virani, assistant professor of medicine at BCM and cardiologist at the Michael E. DeBakey Veterans Affairs Medical Center, said this responsibility falls on both the patient and the health care provider.
"One problem is medication adherence. Not everyone continues to take their medications regularly, and that can be harmful," said Virani. "We know from studies that cardiovascular medications improve outcomes. However, those who participate in research usually are considered to be ‘perfect patients.’ They are more likely to stay on track with their medications, and that’s not always the case with the patients we see in our office."
By using what is known as “refill data” (frequency of prescription refills), doctors have been able to see that nationally, adherence to medications is on average only about 50 percent. Virani said that one of the solutions to improving medication adherence, and therefore health, is communication and education.
“First, patients should understand why they are taking a particular medication," said Virani. "If they don't know why or how these medications work, the chances are they may not take them regularly."
Patients should ask questions, and medical professionals should make sure their patients understand the reasons why a particular medication is prescribed. Another topic to bring up is what are the risks and benefits of the therapy that is prescribed.
"A lot of times there are reports that certain medications have harmful side effects or patients may have experienced side effects. When you hear that or actually experience side effects, patients should talk to their health care provider rather than just stopping medications," Virani said. "Many times, your risk off of the meds could be far worse than the side effects. In addition, discussing these side effects with your health care provider might allow your health care provider to look for reasons as to why you are having a side effect to a particular medication."
Virani said that a conversation with your doctor can help you make the right decision on whether to continue or change your medications. There are also other options that could improve a patient’s adherence to medications which are not related to the side effects of the medication per se. These include the use of generic medication, the use of once-daily medication as compared to multiple doses and the use of a 90-day refill rather than a 30-day refill.
Dr. Vijay Nambi, assistant professor of medicine at BCM and a cardiologist at Harris Health's Ben Taub Hospital, Michael E DeBakey Veterans Affairs Hospital and Methodist DeBakey Heart and Vascular Center, said follow-up visits are also an important part of maintaining one’s heart health.
"That is the time to get your 'report card' and make sure that your risk factors are well controlled. Also these visits let you discuss with your doctor concerns with your treatment or bring up questions you may not have thought of at your previous visit," Nambi said. "Having knowledge of your risk factors and how well it is controlled will go a long way in helping to reduce the risk of cardiovascular health problems."
Discuss your risk factors and how to control, reduce or prevent your chances for cardiovascular disease. Nambi said this includes your family health history.
"Ownership of risk factors helps a person take control and make changes," he said. "Medical professionals can help by explaining why it is important to control and give tips on how to do that."
Nambi also suggests independent reading about your risks or your diagnosis but then bringing any questions to your doctor to discuss and avoid making decisions on your own.
Taking ownership also involves keeping your other doctors included in any decisions your cardiologist might make. Ask for copies of your medical records or charts to share with your other health care providers.
"The doctor-patient relationship is a partnership," Nambi said. "Information, participation and commitment from both sides is equally important."