Disease and affluence (or the lack of it)

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Diseases vs economic situation

A pharmacist friend reported the following cases to me as we were having a tea time discussion.

  • A 45 year old man came with the diagnosis of diabetes and hypertension. His prescription included, glibenclamide 5mg, once a day, metformin 500mg once a day, enalapril 5mg, once a day, Vitamins and calcium. His height was 154 cms and weight was 68kgs. My pharmacist friend advised the patient to take the glibenclamide 15 minutes before breakfast, BP medicine 30 minutes after breakfast and metformin after lunch. He gave counseling based on a brochure on the importance of diet control, exercise and taking medicines timely and regularly. He was advising the patient on the importance of avoiding foods like samosa and biryani, especially those bought from roadside stalls, when the patient smiled and gave a response. He said "I am a cleaner for a bus. I have three growing children to feed. I work from morning to night. There is no chance for me to eat biryani."

My friend told me he felt really bad, giving advice and telling things that do not suit the situation.

A few years ago, BP and diabetes were called lifestyle diseases. Why are they hitting the poor now? What is wrong and where is it wrong?

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About the Author

Prof. J. Vijaya Ratna's picture

Dr. Vijaya Ratna Jayanthi serving Andhra University College of Pharmaceutical Sciences as Chairman, Pharmaceutical Technology Department.

Dr. J. Vijaya Ratna did her B.Pharm (1977), M.Pharm (1979), PGDAS (1981) and Ph.D (1998) at Andhra University Campus and won "M.L. Khorana Gold Medal" for standing University FIRST in graduation.


A.R.Khan's picture

Thanks for sharing this Madam. Appreciate it. We really have to see the context when patient is not happy .

Poor may not be eating right food or on right time because of economic condition.

Rich may be eating junk..

Anyway patient counseling is more of an art than science.

Also, as a pharmacist we need to honor patient privacy . In lot of developed countries we (pharmacists) are not suppose to ask their personnel information ..

Prof. J. Vijaya Ratna's picture

Dear Khan Sir

Thank you for your input. Yes, at the time we were starting our Pharmacy Practices room, we were warned by our hospital superintendent that at all times we must be professional. But sometimes, when we tell patients to eat vegetables and fruits, they respond by coming out with their situation. We cannot help but listen. We try to manage it somehow. But your point is right and we should not probe. And it is not done in our place.

Vijaya Ratna

A.R.Khan's picture

Yes Madam. You are right . We need to be emphatetic to patient situation without crossing the line . Thats where the "art" part of the behavior plays .

If patient counseling is a science , pharmacists will be replaced by machines immediately as filling prescriptions can be done by machines . We need to keep the edge by serving the community .

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