///New Questions: Lifesaving Medical Advances Open the Door for New Comorbidities
January 14, 2019

New Questions: Lifesaving Medical Advances Open the Door for New Comorbidities

In 1996, a 20-year-old American diagnosed with HIV was not expected to see their 40th birthday. Today, they can plan on living into their 70s.

Similarly, a person with cystic fibrosis can expect to live into their 50s today, whereas half a century ago they weren’t expected to live past the age of 10.

Medical advances have helped millions in this way, changing rapidly lethal diseases to incurable but manageable chronic conditions.

U.S. laws such as the Orphan Drug Act of 1983, the Rare Disease Act of 2002, and the 21st Century Cures Act of 2016 have provided incentives and funding to bring new, life-changing treatments to patients. Similar legislation around the world has reflected these goals, promoting innovative research and offering hope to patients and their loved ones.

These changes, and their results, are wonderful. However, they have created entirely new frontiers for scientists and clinicians. As patients’ lives stretch for decades longer, a host of new considerations appear. For instance:

  • What should an HCP discuss with a young adult with a chronic condition who is considering pregnancy?
  • What additional tests and screenings should be done as a patient enters adulthood? Middle age? Menopause?
  • Are there specific new milestones at which medications should be reconsidered?

A variety of medical circumstances may be at play:

  • As patients age, decades of living with a difficult condition may increase the likelihood of developing comorbidities. For instance, having cystic fibrosis can increase the chance of developing osteoporosis, diabetes, and certain cancers.
  • Simultaneously, long-term use of some medications may cause new comorbidities.
  • A person’s metabolism changes throughout their lifespan, and these changes can cause medications to work differently than they once had.
  • The likelihood of polypharmacy – using more than one prescription – increases as a person ages, and this can create unexpected interactions with previously well-tolerated medications.
  • Handling a lifelong condition and all of its ramifications can be extremely difficult, and can increase the risk of developing depression or substance abuse.

Healthcare professionals and researchers are working to address these new concerns. As one author wrote in the American Journal of Nursing:

Given this improved prognosis, the age composition of this clinical population has also changed and nurses and allied healthcare professionals are scrambling to know what the clinical characteristics of this emerging population are and what they need to know in order to provide the best evidence-based care for them.

Pharmaceutical marketers can take a leaf from clinicians’ books. Are you privileged to work on brands that save and extend people’s lives, as many of us are? If so, are you taking into consideration how your patients’ journeys have changed over the decades? Your patients’ concerns may be different from what you – and even the current state of science – have historically assumed.

It’s time to wipe the slate clean of assumptions and really consider: What are your patients worried about for this new year … and for their years and decades ahead?