Medical Files
Free checkup, treatment, allowance for hypertensive patients
By Rafael Castillo, MD
Philippine Daily Inquirer
First Posted 21:46:00 04/25/2008
MANILA, Philippines—May 17, this year, is the World Hypertension Day celebration coordinated by the World Hypertension League (WHL).
In the local front, various medical organizations such as the Philippine Society of Hypertension (PSH), Philippine College of Physicians (PCP), Philippine Heart Association (PHA) and the Stroke Society of the Philippines (SSP), together with partners in the pharmaceutical industry, are joining efforts to flush out some six million Filipino hypertensive patients who don’t even know that they have this risk factor which can land them in the hospital in the middle of the night due to a stroke or heart attack.
Starting on the second week of May, there will be blood-pressure screenings in various centers together with free ECG (electrocardiogram) and blood tests in selected areas. The culmination of activities will be on May 17. Look for the banners with the PSH, PCP, PHA, SSP and WHL logos.
Big treat
Selected hypertensive patients are also in for a big treat for the month of May. Forty patients with documented high blood pressure (140/100 to 180/120 mm Hg) on repeated determinations will be entitled to free regular laboratory checkups, medicines to control the high blood pressure, plus transportation and meal allowance every time they come for checkup (P1,000 per checkup). Too good to be true? Well, for 40 lucky ones, it’s true. And there are no strings attached.
The patients will not be asked to do anything to pay back the study investigators nor the sponsors for the series of studies. This is a pure scientific undertaking one of the aims of which is to show that with good medicines and good compliance on the patient’s part, hypertension can be effectively controlled.
The total benefit package is estimated to run up to P60,000 if the patients are able to complete the series of clinical studies which will run up to a maximum period of 12 months. If the patient’s compliance is poor, he may be taken out of the study after only a few weeks.
This is part of a clinical trial program of tried and tested drugs for hypertension. These medicines are already currently available in the market and if they are bought, patients may spend up to P100 daily. For the duration of the study, patients will be followed up regularly and evaluated by cardiovascular specialists.
Biggest reward
Although the savings in the cost of medicines, specialist consultation and laboratory evaluation should be a strong incentive for the 40 chosen patients, this should not be their main consideration. Their biggest reward is to have their blood pressure adequately controlled with effective drugs that have been proven not only in bringing down the blood pressure, but also in preventing complications like heart attack, heart failure, stroke and premature cardiac death.
Only medicines for hypertension will be provided in the study. Medicines for other concomitant problems such as diabetes will be prescribed, but will not be provided. All those who are interested may call the study coordinator, Lilet Agnes, during office hours at 892-0723 or 24, or cell phones 0919-623-0205 or 0919-886-8409.
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Dr. Bernard Canlas, continuing medical education director of the Institute of Pain Management, Jacksonville, Florida, USA and president of the American Pain and Spine Institute of Manila is currently in town to give a series of lectures titled “Breaking the Opioid Myth: Perspectives in Optimal Pain Management.” He spoke at the Philippine Society of Medical Oncologists’ annual convention earlier this week at the Edsa Shangri-La Hotel. He will also talk on the management of chronic pain at the Pain Society of the Philippines’ annual convention tomorrow at the Baguio Country Club.
Dr. Canlas is Board Certified and a Diplomate of the Philippine Board of Anesthesiology, American Board of Anesthesiology, American Board of Pain Medicine and Subspecialty Certified in Pain Medicine by the American Board of Anesthesiology.
Serious problem
I’m sure Dr. Canlas can help clarify a lot of issues on pain management. Inadequate pain relief is still a serious public health problem and even doctors admit there is a lack of knowledge of medical standards. Hence, sufferers of chronic pain are somehow shortchanged in that they don’t get the relief and comfort they deserve to get.
There is still a gross misunderstanding about prescribing adequate amounts of controlled substances such as opioids, with an exaggerated concern for addiction and dependence even in terminally ill patients whose remaining weeks or days of life are made a lot more miserable with severe pain brought about by their illness. Opioids are still the most effective drugs for severe pain control, and the average physician feels wary to prescribe them because of the fear of addiction by the patient, who sometimes only have a few months to live.
Accepted principles
Some accepted principles of pain management include the following:
• Relief of severe pain is a basic right of the pain sufferers and they have the right to have their pain relieved to the greatest extent possible.
• Fear of addiction to opioids and other pain medications is sometimes exaggerated and should not be a barrier to pain management.
• Tolerance and physical dependence are consequences of sustained use of opioid analgesics and are not synonymous with addiction.
• Pseudoaddiction is a pattern of drug-seeking behavior by persons with pain who are fearful of receiving inadequate pain management, and are frequently mistaken for addiction.
• Even persons with a history of substance abuse have the right to adequate pain relief, even if opioids must be used. Such persons may require specialized care though.
• Pain management should be maintained even in patients with depressed sensorium (drowsy or stuporous) or if the person is already unresponsive.
I’m sure our local pain experts can benefit a lot from this series of interaction with Dr. Canlas.
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