Dear Dr Makis
I have been living in Cyprus for 2 years. Before I moved, I was being prescribed medication for my diabetes and high blood pressure from my GP in the UK. I am not registered with a Gesy GP here in Cyprus, so I just buy my medication from the pharmacy. The pharmacist asked me if my blood pressure and diabetes was well controlled. I have not had any checks since coming to Cyprus, but I feel completely well. Is it OK to just continue buying my medication without seeing a doctor?
You are taking medication to control and manage chronic diseases. These are conditions that we have developed and are like
ly to be present for the rest of our lives. With appropriate medication these conditions can remain well controlled and cause us little or no problems in the future. These chronic problems often do not have symptoms, for example hypertension (high blood pressure), but if not well controlled then they can lead to the development of significant disease such as angina, heart attacks and strokes. You are taking medication to reduce the risk of these life limiting and life-threatening conditions happening, we call this primary prevention or preventative medicine. The process of monitoring this is called chronic disease management.
The earlier we pick up these chronic diseases and the better that they are controlled, then your risk of associated heath issues in the future reduces. This is the reason for you taking this medication.
You should be reviewed annually by a doctor to ensure your chronic conditions remain well controlled and that you are not developing complications associated with these conditions. A doctor is able to ask you the correct questions, examine you, check you blood tests and ensure that you are taking the appropriate medication and that you are also taking it correctly. Blood tests can tell us if your diabetes is well controlled or not, but also it can tell us that the medication you are taking is not causing you harm.
Medications we use to treat chronic conditions have been thoroughly researched and approved for use by governing bodies such as the MHRA (Medicines and Healthcare products Regulatory Agency) in the UK and the EMU (European Medicines Agency) in the EU. This scientific research forms the basis of clinical guidelines that doctors should follow to ensure that you are receiving the correct treatment and medication for your conditions. This said, these medications can sometimes cause
unwanted effects such as changes in your kidney function, liver function and the electrolyte imbalances in your blood which can cause you harm. It is therefore essential that this is monitored through regular blood tests to check for this. As doctors, we do not want medication or treatment that you have been advised to take to cause you harm, we want you to benefit from taking it.
The final reason you should have an annual review with a doctor is to ensure that the medication you are taking is still the correct medication. Clinical guidance on managing chronic conditions updates and changes regularly as more medical studies and research takes place. You may have been advised to take a certain type of medication in the past but clinical guidance may have changed since then.
You should receive a full medication review when you see the doctor who will be able to check that what you are taking is still up to date for your condition, if not they can discuss with you what the alternatives may be.
Even though you can buy your medication from the pharmacy here in Cyprus, and I appreciate you feel completely well, but spending a little time with a doctor to get a formal review can benefit your health in the long term.
Dr Makis offers medical advice via his monthly article in the Paphos Post newspaper. If you require personal medical advice, contact your own GP in the first instance. For further information about Veramedica Medical Center, please contact us.