Thursday, April 14, 2011
By Dr. Anthony Policastro

Patient compliance is the term used for patients following a treatment plan as prescribed. The degree of compliance varies with the disease, treatment and the individual. We know that only about 50% of patients actually follow a drug plan for a chronic disease. This is true for asthma, diabetes and high blood pressure. Patients are sometimes anxious about telling their doctor the truth about how compliant they are. They may feel that the doctor will think less of them. They may feel they will get chastised and that a little white lie never hurt any one. Unfortunately, there are some real dangers to not being honest with your physician. Since half the patients do not take their medication, it will not be a surprise. In addition, the doctor can often tell by how frequently you ask for refills as to how compliant you are. I prescribe ADHD medication. I cannot give more than a month supply at a time or refills - both are federal requirements. When I see patients back I can see how many months they missed a prescription. Even when it is clear that they did not have enough pills to give them every day, they will often insist that they did. The important piece of this is not telling your doctor the truth, it is about what happens if you do not. When you get evaluated for certain conditions, the physician measures things such as blood pressure for hypertension; blood sugar or Hemoglobin A-1-c for diabetes; cholesterol levels; a thyroid test for thyroid problems; or a breathing test for asthma. When the results come back the physician needs to make a decision about the next steps. If he/she knows that you have not been taking your medication regularly, the next step is to advise that you do so. Once you do, the test can be repeated to see if it improves. However, if the physician does not know that you have been non-compliant, there are several options open. None of them are really good. The first is to switch you to a different medication. It does not make a lot of sense to give a new medication that will still not be taken. In addition, the first medication used is often the best one for that particular problem. It also might be the one with fewer side effects. The result is that you might get switched to a less effective medication with more side effects. A second possibility is to give you a higher dose of the medication that you are already taking. The higher a dose of a drug the more likely there is to be side effects. The result is that you might take a higher dose than you need. You will then have side effects that you do not need. A third possibility is that an additional drug can be given. You will then have all the potential side effects from a new drug. You will also have the possibility of a drug interaction with other medication that you are taking. None of these three possible approaches would be the right one. The right approach is to tell the physician that you are not taking your medication as prescribed. The first step is to use the medication correctly which would avoid a whole series of other problems. We physicians know that half of our patients do not take their medication as prescribed. However, when we talk to them in the office close to 100% tell us that they do. That means half of the people we see are being less than truthful. It can significantly affect your medical care if you are not truthful. The best thing to do is be one of the 50% who does take their medication regularly. If you are not in that group, the best approach is to be honest with your physician so that you do not create other unnecessary risks for yourself.

Children's scoliosis screenings Nanticoke Chiropractic Center will offer free scoliosis screenings and information to children between the ages of5 to 12 on Tuesday, April 19, from 5:30 to 6:30 p.m. Stop by our office for a quick visit to ensure your child's spine is properly developing. The center is located at 415 W. Stein Hwy., Seaford. For more information, call 628-8706.

Cancer support group The Wellness Community-Delaware offers a free general cancer support group for people affected by cancer and their loved ones at Nanticoke Memorial Hospital in Seaford. The monthly support group meets in the first floor resource library of the Cancer Care Center on the third Monday of each month. The next meeting is April 18 from 3:30 to 5 p.m. The Wellness Community, an affiliate of the Cancer Support Community, is dedicated to helping people affected by cancer enhance their health and well-being through participation in a professional program of emotional support and hope. All facilitators are trained mental health professionals with a master's degree or more. Call 645-9150 for information or to register for this program. This program is made possible by the support of Nanticoke Memorial Hospital.

Test added to newborn screening The Delaware Division of Public Health's (DPH) Newborn Screening Program (NSP) currently screens all newborn babies for over 37 rare health disorders which if left untreated could cause developmental delay, serious medical problems, or even death.

This year, the NSP will add Severe Combined Immunodeficiency (SCID) to the newborn screening panel. Disease prevention should start as early in life as possible. SCID is a group of disorders characterized by a deficiency of the immune system, affecting approximately one in 100,000 newborns. Infants affected by SCID develop recurrent infections leading to death in early childhood. Treatment in the first months after birth can prolong life and prevent infections. The newborn screening test that suggests the presence of SCID can also detect a number of other congenital disorders of the immune system. Babies with these disorders may appear well at birth. SCID testing will begin in the DPH laboratory pending staff training, equipment delivery and the implementation of supporting data systems. Disease prevention produces costs savings to the health care system. For every $1 spent on newborn screening it is estimated that between $2 and $4 are saved. For more information about the DPH NSP, visit

Stroke Support Group Nanticoke Memorial Hospital's next Stroke Support Group meeting is Tuesday, April 19, at 1:30 p.m., at the Seaford Library. The support group is designed for individuals who have survived a stroke as well as their families and caregivers. The two-hour support group meetings will consist of guest speakers and breakaway sessions, in which caregivers and stroke survivors will meet in two groups to discuss concerns, provide support and allow for networking. Refreshments will be provided. Pre-registration is not required for this free support group. For more information, contact Nanticoke Memorial Hospital at 629-6611, ext. 8626.

Healthy Brain workshop The University of Delaware Cooperative Extension along with its Sussex Mental Fitness partners invite the public to attend the "Brain Healthy Lifestyle: Feed Your Spirit" program on Thursday, April 28, from 1 to 5 p.m., at the Cordrey Center in Millsboro. The event is free, but pre-registration is required in order to plan for refreshments that will be provided. Register by calling 856-5618. Doors open at 12:30 p.m. for check in. Young, old, or in between, it is never too late to challenge our brain and allow it to work for us at peak capacity. Practicing a Healthy Brain Lifestyle not only enhances your overall health by promoting exercise and nutrition, it asks your brain to work in new ways which helps to prevent diseases that can manifest in our more mature years. Featured speakers include Brent Marsh, Attracting Song Birds & Other Wildlife using Native Plants; Dr. Kim Furtado, Effects of Stress on Memory; and Stan Raskin, LaughterÉRx for a Healthy Brain. The Cordrey Center is located on the grounds of East Coast Garden Center, 30366 Cordrey Rd., in Millsboro.

Breast cancer support group Delaware Breast Cancer Coalition, Inc. (DBCC) has expanded its Beginning Your Pink Ribbon Journey, a program for women newly-diagnosed with breast cancer, by partnering with Nanticoke Memorial Hospital Cancer Center in Seaford. The free, monthly program is offered at the Cancer Center located at 801 Middleford Road, Seaford, the third Thursday of each month from 3 to 4 p.m. Of particular value to newly-diagnosed women is DBCC's Peer Mentor Program through which they are paired with a long-term survivor for one-on-one support. To learn more about Beginning Your Pink Ribbon Journey at Nanticoke Memorial Hospital Cancer Center, call Lois Wilkinson at 672-6435. Registration is required and light refreshments and small gifts are provided.

Bereavement luncheons Delaware Hospice's "New Beginnings" bereavement luncheons are an informal way to meet and talk with others, who have had similar loss experiences. Lunch begins at noon and is followed by a brief program. The location rotates each week of the month according to this schedule:
  • 1st Thursday: Grottos Pizza, Rt. 26, Bethany Beach;
  • 2nd Thursday: Georgia House, 300 Delaware Ave., Laurel;
  • 3rd Thursday: Millsboro Pizza Palace, Rt. 113-southbound lane, Millsboro;
  • 4th Thursday: Blue Ocean Grill (formerly Milton House), 200 Broadkill Rd., Milton;
  • 5th Thursday (when applicable): Texas Grill (formerly Ocean Point Grill), 26089 Long Neck Rd., Millsboro. "New Beginnings" luncheons are open to the public. Registration is not required.There is no fee except the cost of your lunch.
For more information, call Carol Dobson or Paul Ganster at 856-7717.