No, you can’t have it.

Since adherence is literally ruling the pharmacy life lately (and rightfully so, truthfully), here’s the typical interaction lately. And why people can be exceedingly frustrating. There is a point to this. Read on.

Uber pharmacist: “Good morning, we’re calling because I see you haven’t filled you blood pressure med in almost 5 months. Shall I proceed to fill ‘er up?”

Wrong priorities: “Why no, no you can’t, because I still have half a bottle left. Your computer must be wrong. But while I’ve got you, how about filling up my Lortab?”

UP: “Why no, no I can’t, since it is a week too early. Nice change of subject”.

WP: “So you’re saying I can’t get my ‘tabs?”

UP: “To put it plainly. No, you can’t. But I can fill your blood pressure meds.”

WP: “But I need my pain meds. I’m out.”

UP: “So you’re saying that you’re out of a medicine you pick up religiously 2 days early every month, and have for the last 3000 years, meaning that in 1 year you have 24 extra days of medication. However, you are somehow are out of that. On the other hand, the medicine that is keeping you from stroking out and dying, you have almost 2 months left, even though you should have ran out almost 2 months ago?”

WP: “…but I take them right. You must’ve shorted me.”

UP: “According to my trusty log and the 3 times it got counted, no, you did not get shorted. Again, nice job at ignoring the obvious.”

WP: “So, if I fill my blood pressure med can I get my ‘tabs?”

UP: “I see what you did there. But still, alas, no. See you in a week”

So, what’s the point of this interesting conversation? At the end of the day, patients respond to what they feel, not necessarily what is best for them. Immediately, a patient will feel anxiety, stress, and pain from loss of their pain medication. They will do what is rational to prevent that; most often that is going to be making sure they don’t run out. On the other hand, because you can’t feel high blood pressure (yes…that’s an old wive’s tale), lisinopril doesn’t seem that important. That is, until the big one occurs.

Our job is simply to highlight the priorities. Yes, pain is not fun. Yes, withdrawals are unpleasant. And yes, patients can be annoying. At the end of the day, we need to refocus that attention to why that lisinopril is important. The pain now is nothing compared to the pain later when a heart attack or stroke occurs. Its like an oil change. Filling up the car with gas prevents an immediate problem of hitch hiking on the side of the road. However…that oil change prevents the long term problem of not being able to use that car forever.

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