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This article originally posted 30 August, 2012 and appeared in  Issue 641

Letter from the Editor #641: Starting ACE-Inhibitors at Diagnosis

This week we have an interesting item from a very large study on the benefit normotensive patients with diabetes can receive by lowering their blood pressure when it comes to the risk of heart attack, stroke, and renal failure (Dramatic Benefits in Diabetes for Small Blood Pressure Drops to Below Normal).  This points to the value of starting your patients on low dose ACE-inhibitor doses as soon as they are diagnosed with diabetes. However it really doesn't matter how many prescriptions for hypertensive medications we write if our patients don't fill them. This fact is really shown when you look at a study published in the American Journal of Managed Care (2009;15(12):871-880).

This study included 6,236 patients with hypertension who had a health plan enrollment for at least 6 months and when the researchers took out patients who did not take their medications they found that more than 40% of patients filled their prescriptions less than at 60% of the time. And approximately 30% of the population in this study was covered more than 91% of the time meaning that even when they can get the medication they won't take it.

Be sure and check out this week's tool, the Understanding Metformin Handout (pdf), the first in an occasional series that provides your patients with an easy-to-use handout that improves compliance. 

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Announcements:

TCOYD CME Conference, Missoula, Montana, Saturday, September 8, 2012

The TCOYD Continuing Medical Education Program offers a unique opportunity to bridge patient and professional education, demonstrating the link between clinical lessons in the classroom to the real life patient experience. Find out more here.

Please answer this week's poll: Have you ever owned a pedometer?

Vote in and then see results from previous polls here.

 
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We can make a difference!
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Check out this week's Test Your Knowledge question.

Dave Joffe, Editor-in-chief 

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This article originally posted 30 August, 2012 and appeared in  Issue 641

Past five issues: Issue 677 | Diabetes Clinical Mastery Series Issue 136 | Issue 676 | Diabetes Clinical Mastery Series Issue 135 | Issue 675 |

 
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