Pack it in

In general, I try to proudly proclaim my heritage as a Canadian

Randall C Willis
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In general, I try to proudly proclaim my heritage as a Canadian—like I have to tell you poor folks. Perhaps it's the "little brother" syndrome my American spouse is so apt to point in my face, but as another Canada and Independence Day pass in North America, I assume my readers will allow me this moment of self-indulgence. But every now and again, my compatriots make my life particularly difficult. This is such a moment.
 
According to recent research conducted by scientists at the University of Alberta and published in the British Medical Journal, it would appear that it is time for all of us to pack it in. That's right. Pack up the glassware. Unplug the mass spectrometer. Quench the magnets. Box the compound libraries. It's time to go home.
 
The researchers performed a meta-analysis of observational data from 21 clinical studies involving almost 47,000 patients and found that whether patients diligently took a beneficial drug or a placebo, their mortality rates dropped significantly—by almost half—when compared to those patients who were less diligent in their pharmacological regimen. So the good news is that being faithful to your drug treatments is good for your health. The bad news is being good about taking sugar pills offers similar benefits.
 
In fact, the researchers and Dr. Betty Chewning of the University of Wisconsin-Madison, who offered an accompanying commentary, suggest that the strong adherence to drug treatment may be indicative of healthy life style and personal practices on the part of patients. As Chewning explained: "It is quite possible, therefore, that people who adhere to healthy lifestyles also tend to take care of themselves by greater adherence to prescribed treatments."
 
But wait. Maybe this explains one of the challenges of the pharmaceutical industry. Silly us. We've been medicating healthy people. No wonder they don't take our pills and tinctures for very long. We should be medicating the sick. They might not be as good about taking the pills, but that just means they'll take them longer.
 
Okay, everybody. Unpack the boxes. Plug the mass spectrometers back in. Time to get back to work. We're going to try developing drugs for sick people. I don't know why I didn't come up with this earlier.
 
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On a serious note, however, the study did offer a particularly important observation regarding adherence to treatment and treatment with harmful drugs. Basically, whereas adherence was otherwise linked to decreasing mortality, the opposite was true in this category. The authors suggest that maybe patients should be stratified during treatment on the basis of adherence, so that clinicians might better identify "harmful therapies if the rate of adverse events is higher in participants with good adherence."
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Given recent challenges regarding drug safety, this might not be a bad piece of advice.

Randall C Willis

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