Rates of high blood pressure and diabetes are high enough in Canada and retirees are at particular risk. But a study just published in the Canadian Medical Association Journal
gives a new reason to blame the patient for the rise.
Turns out that retirees don't take their medications. Researchers from Finland, the UK and Sweden looked at the habits of more than twenty-one thousand retired government workers in Finland. They looked at the number of prescriptions that the government workers filled in the three years before
they retired and the four years after
they retired. What they found is that following retirement, both men and women more likely to stop taking their blood pressure medications. And, while women continued to take their diabetes medications, men were more likely to stop taking those pills as well.
You're probably thinking it's because they couldn't afford to purchase their medications. By design, the study took ability to pay out of the equation. It turns out that rich or poor, they were all less likely to take their prescriptions. The authors theorize that retirees lost the daily routine of which pill taking was a part. Another factor that may play a role is that upon retirement, the workers felt healthier because they no longer had the stress associated with work. Feeling better subjectively, made them more likely to stop taking their medications.
If that was the motivation for stopping their medications, they're making a big mistake born of misperception. You feel stress at work and perhaps you feel less stress when you retire. Then again, retiring can be just as stressful as working. But all of those things don't take away from the fact that high blood pressure and type 2 diabetes are silent
conditions. You can't tell how high your blood pressure or your blood sugar is by how you feel. Retired or not, as people get older, rates of high blood pressure and diabetes uniformly go up.
This was a study of government workers in Finland. Any chance Canadian workers would behave any differently? There's no reason why Canadian retirees would be any more or less likely to take their meds than retired workers in Finland. This is a new part of a much larger issue of what we call medication non-compliance. Roughly half of all Canadians don't take their prescriptions properly. A 2013 study
found that more than 20% of patients who were just discharged from hospital don't take their medications either!
They take them inconsistently or not at all. Many strategies are being tried to reverse the trend: checklists, devices that monitor compliance, getting pharmacists to counsel patients, to name three. No matter what they try, it's still a problem.
The implications of this study are quite troubling. In Canada, we have rising rates of diabetes and high blood pressure - both of which are risk factors for heart disease and stroke. We also have rising numbers of Canadians who have retired or are going to retire in the next ten years. If a lot of those retirees don't take their prescriptions, then we'll end up with even greater numbers of Canadians with heart disease and stroke.
There may be a silver lining here in that we might be able to bring the number of Canadians with heart disease down significantly by getting more retirees to take their medications.
If I could wave my magic wand, that is where I'd look to have the greatest impact.