Doctor in Fruitport provides education and support to patients with high blood pressure
One of the challenges with helping patients control their high blood pressure is convincing them that it’s important, says Dr. Darrell Roelandt, who practices in a residency clinic in Fruitport. The doctor says his clinic helps patients by providing education about blood pressure and offering resources to help people get care or medications.
Dr. Roelandt takes the time to educate patients and answer questions about their condition. He first approaches patients by explaining why it’s important to keep their blood pressure under control. “If patients need further education or support, then I set up an appointment with the staff pharmacist to discuss blood pressure, lifestyle changes and possible medications,” he says.
The office also has nurses who help educate patients. They also answer patients’ questions and return calls within 24 hours.
For patients with high blood pressure, Dr. Roelandt requires follow-up visits once or twice a year, especially if they’re on medication. "If a patient has isolated hypertension, we try lifestyle modifications before putting them on medication,” he says. “That’s sometimes difficult for patients. You’re asking them to make lifestyle changes, especially with diet and exercise.” And even if they make those changes, “many patients end up with medication,” adds Dr. Roelandt. Patients with underlying conditions, such as diabetes, are usually put on medications sooner.
Because many patients are on blood pressure medications, part of the education process also addresses medication compliance. One of the barriers to staying on medications includes the side effects. “I warn them ahead of time about side effects,” says Dr. Roelandt. “The most common one is fatigue or dizziness for the first couple of weeks. That is the body getting used to having a more normal blood pressure,” he explains.
One of the side effects with ACE inhibitors is a persistent cough. Dr. Roelandt will sometimes switch patients to other drugs if the cough becomes problematic. If Dr. Roelandt is concerned about side effects with medications, sometimes he will ask patients to take blood pressure readings at home. Patients will then call the office with the readings or bring logs to their follow-up appointments.
Costs and transportation can also be barriers to some of Dr. Roelandt’s patients. Many of the clinic’s patients are uninsured or underinsured. “We have a social worker on staff available to talk to patients who have cost barriers,” he says. “The social worker helps patients obtain resources to help alleviate the cost of medications.” The social worker also helps patients explore insurance options through the Health Insurance Marketplace as part of the Affordable Care Act and helps patients arrange transportation to the office for follow-up visits.