美国国家公共电台 NPR Drug Test Spurs Frank Talk Between Hypertension Patients And Doctors

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NOEL KING, HOST:

There is an uncomfortable irony¹ at the center of treatment for high blood pressure. High blood pressure itself often doesn't make people feel that bad, but the medicines used to treat it can make people feel lousy, so some people don't like taking their meds. Now a drug test is available to check if patients actually are taking them. Blake Farmer of member station WPLN in Nashville has the story.

SHARON FULSON: It's starting.

BLAKE FARMER, BYLINE²: Sharon Fulson has her own blood pressure monitoring cuff³ at home because blood pressure is a moving target.

FULSON: Being on the radio might have an effect on me (laughter).

FARMER: Even being in a doctor's office can add enough stress to elevate their results. They call it white coat syndrome⁴. And this is why testing a patient's blood pressure doesn't confirm for cardiologists whether a patient is taking the medication.

FULSON: It's not that you don't want to take it, because you know it's going to help you, but it's the getting used to it.

FARMER: The daily pills make Fulson feel groggy⁵ and nervous. Men can have trouble with arousal. Many report dizziness, nausea⁶ and diarrhea.

FULSON: All of these side effects is worse than the high blood pressure.

FARMER: Hypertension really doesn't have unpleasant symptoms until you have a stroke or a heart attack. That's why it's called the silent killer⁷. Sarah Avery says hypertension runs in her family - her mother, grandmother and her late father.

SARAH AVERY: My daddy died because he didn't take his medicine.

FARMER: Still, the medication is such a drag, she's decided⁸ at times to stop without consulting her doctor.

AVERY: I lied. Really, I lied. He said, you taking your medicine? Mmm hmm. I said yeah, my momma made sure that I do. I was just lying.

FARMER: Research shows half of patients, maybe more, are like Avery and don't take their medicine like they should, even though heart disease is the leading killer in America. Avery had her own brush with death.

AVERY: I had a stroke, and that was because I wasn't taking my medicine.

FARMER: The medical community believes some of the complications could be avoided with better compliance⁹. So this new drug test from Aegis¹⁰ Sciences may inject more honesty into the doctor-patient relationship.

(SOUNDBITE OF SCREENING MACHINE)

FARMER: Most of the time, this Nashville lab screens urine samples for drugs that shouldn't be there. This works the other way. Lab manager Jana Case says the machines search for all kinds of blood pressure and cholesterol¹¹ medication.

JANA CASE: In that one injection, we can detect the 80-plus drugs. Results come out within about three minutes.

FARMER: The test only can tell whether a patient has taken pills in the last day or two, but CEO Frank Basile says it's at least a starting point.

FRANK BASILE: What we give doctors is a tool that enables them to have a very focused conversation with their patients, first of all, to bring the problem into the open and then to talk about, you know, exactly why.

FARMER: This has been effective for cardiologist Bryan Doherty, who works in a relatively¹² rural Tennessee community. Tests he did on one man showed he hadn't been taking his medication.

BRYAN DOHERTY: He immediately turned around and told me that the cost was an issue. And I think there was a degree of, you know, embarrassment¹³ there, potentially, or feeling like he was letting me down in some way, something that had not come up in a 25-minute initial encounter when we'd spoken before.

FARMER: Of course, the test has a cost, too - about $100, though Doherty says insurance seems to cover it. And he says there are usually other drugs that are less expensive and other drug options that have fewer side effects. He says it's worth the potentially uncomfortable discussions between doctor and patient because the medication might make the difference between life and death. For NPR News, I'm Blake Farmer in Nashville.

KING: And that story was part of a reporting partnership¹⁴ with NPR, WPLN and Kaiser Health News.