There is a lot of “lip service” to pt’s medication compliance


All healthcare professionals, PBM (Prescription Benefit Managers – Express Scripts) and insurance companies and other are all focused on pt compliance with their medications. Currently and historically, pt on-going compliance has been in the 30% range.

Many healthcare professionals seem to like to bend the truth with talking/dealing with chronic pain pts or pts with subjective diseases.  There is no clear measurement of the intensity of a pt’s pain.. unlike blood pressure, cholesterol, blood sugar.

Normally prescribers will not hesitate using multiple medications in treating resistant high blood pressure, cholesterol, high blood sugar or other chronic disease states… to get the pt’s lab values within “normal range” or as close to normal range as possible.

Let’s look at the normal “pain scale” in a different concept.  If a healthcare professional is reluctant to adequately reduce a pt’s pain level. Perhaps the pt’s discussion with the prescriber/healthcare provider be more in relationship to how they treat other chronic disease states.

Instead of looking at the 1-10 scale… look at your pain being 10% -100% above normal range. Lab values with any chronic condition is going to vary as much a chronic pain pt’s intensity of pain varies..

You need to ask the prescriber what the level of pain – on average – they expect you to accept.  For example, they come back with >5.. I would come back with the question.. do you target other chronic conditions with a 50%+  above accepted values as you goal..  For example, normal blood pressure range is 80/120… so at 50% above normal range is 120/180.. Is this an acceptable target range for one of your pts with high blood pressure ? Of course, a pt with a diastolic pressure (lower value ) of 120… there is a high probability that the pt will suffer a stroke or kidney damage within 2 yrs.

You might want to share this 10 yr old report on the   Consequences of unrelieved chronic pain ?

If your prescriber has not done DNA testing on you or has not hear of DNA testing in regards to fast/slow metabolism of opiates you might want to share this with them  You may need a higher dose of opiates to manage your pain because …

You may be able to “paint them into a corner” and get them to admit that they are discriminating against your chronic pain as opposed to other pts that deal with other chronic disease issues.


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