In her 2024 Wellness Academy lecture, Heather Martin, PharmD, explored the intersection of wellness and medication, providing insight into how some people may be able to decrease medication use through healthy lifestyle changes.
In this Q&A session, Martin addresses medication use for chronic conditions, the science of forming good habits, and working with your physician on a medication plan that is right for you.
About the expert: Heather Martin, PharmD, BCACP, CDCES
Heather Martin, PharmD, serves as the Manager of Primary Care Pharmacy at UC Davis Health. A seasoned clinical pharmacist and Certified Diabetes Care and Education Specialist, she is passionate about reducing medication dependency through patient education and behavioral change. Dr. Martin holds a PharmD from the University of Florida and completed her residency at the University of Illinois Chicago, further enriching her expertise with a certification in Health and Wellness Coaching.
Q&A with Heather Martin, PharmD
This transcript has been edited for clarity.
Q: Do you have any recommendations about which changes would benefit patients who are hoping to reduce or eliminate medication use for chronic conditions, such as hypertension and diabetes?
Dr. Martin: Yeah, I think that’s a great question. And it is something I think, to keep in mind and discuss with your physician as well, in terms of priorities, particularly if you have multiple health issues you’re trying to face at the same time. That said, if there were one thing I could think of that seems to be most associated with reduction in medication use, I tend to find really maintaining a healthy weight can be fantastic preventative, strategy for multiple chronic diseases.
Whether that’s high blood pressure, whether that’s diabetes, we see that a lot of different factors improve when you can maintain a healthy weight. And in some cases, that’s not losing very much weight. Like for blood pressure in particular even losing as little as 10% of your body weight, which may not be a weight you have in mind for wearing a certain outfit from high school or looking a certain way, but little small shifts in your body weight can really make a big impact on your health outcomes and decrease the need for medications to treat them.
Q: What about the collaboration with patients and their physician and their pharmacist? Do you have any tips from the coaching aspect of things as to how they would go about interacting with their physician?
Dr. Martin: Yeah, I think that’s an interesting question. And I will say that I think timeline is highly individualized and really variable based on each person’s current state. Where are they at and where are they trying to get? But probably just really having open conversations with your physician about what your goals are and asking them as well, you know, how urgent is it that I address this issue in X amount of time? Maybe making a commitment with your physician that you like to try it this way for three months or six months before you make that that switch to medication use.
So, I think just really having a partnership with your physician to understand your specific risks, and, you know, setting some goals, and asking for those opportunities to incorporate the wellness aspects because it will take time to adopt any new habit. Right? There’s a lot of research on healthy habits that says you really need three weeks at minimum to start to feel comfortable with a new habit.
And more likely, the more time you practice with that habit, whether that’s a diet change or an exercise change, the longer it is likely to stick and become second nature. So, I think just having those open conversations and really being clear about what your goals are, but also remembering that it’s not a failure or a shame if you do need some medication.
There are some conditions where medications would be the best option, and particularly if your risk is high for a very negative outcome, you may want to start medication right away as you try to attempt these wellness goals and then look towards being able to remove [the medication] at a later time, if that’s what’s best.
Q: Why do we so easily default to the bad habits and find it so difficult to acquire the good ones?
Dr. Martin: Oh, that’s an interesting question. I well, I would suspect if we’re going to use terms bad and good, which some, like coaches or dietitians would not want you to use to categorize anything as bad or good. I would say some of the more challenging habits, right, that seem to have negative health consequences, such as smoking, maybe enjoying high fatty, high salt or high sugar foods that could contribute to different health problems, including weight gain.
Unfortunately, it’s somewhat of our biology, right? Our body as animals, as mammals, we’ve developed to seek out certain elements in food because they may be scarce at times when we didn’t have the conveniences of supermarkets and refrigerators and kitchens and food was less plentiful. And so, we are somewhat hardwired to enjoy those things and to seek those things. And so, they may be a bit easier to crave. And then for things like smoking, you know, nicotine is obviously addictive.
We know that alcohol can have certain pleasurable characteristics which could also cause people to want to partake more than maybe is a healthy limit. So, I think it’s just really a challenge. You know, we’re fighting against some things that are pleasurable to some degree, but when overdone, can have negative health consequences.
So, I think looking to find the pleasurable aspects of exercise or looking to find the pleasurable aspects of trying new or healthy foods or substituting maybe healthier options can really help you to increase those chances of having those healthier habits stick a little bit. So maybe if you’re reluctant to be more active, but you really enjoy socializing, finding a buddy who can go with you, who can be a partner for a walk or a taking a fitness class, then then the reward of having that socialization may offset some of the challenge for you if you aren’t really intrinsically motivated to be active.
Q: What are your thoughts on patients that are looking toward optimizing health and wellness before disease states?
Dr. Martin: Sure. And I will say, you know, as a pharmacist, a lot of what we learn about medication use is really founded in science and research. And one challenge with supplements is that they are not regulated in the same way as medications. They may not have the same requirements to do a rigorous scientific studies or challenges to sort of prove if the benefits outweighs the risks.
So, from that regard, I would say there’s less clear evidence that would recommend any one supplement as having, you know, a magic formula or something. Everyone should take an approach I’ve sort of used when working with people who have an interest is to on an individual level assess if that supplement that you’re interested in [is right for you]. You know, what are your motivations for that? What are you looking to achieve? Are there going to be any known negative risks from you taking that, which may include interactions with other medications that you use? And then it does become somewhat of a personal preference.
If that’s really important to you and it’s something that you really want to try, and it doesn’t seem that it’s going to have a negative consequence that we’re aware of or a drug interaction, then sure. It might be reasonable if that’s important, that you want to give it a try. So, I can’t say that any one, you know, supplement sticks out as like a mandatory thing, in certain instances. You know, different vitamins might be recommended, but I think the best vitamins you can get is just from a really healthy, well-balanced diet. And then most of the time when in health care, physicians or pharmacists are recommending supplements, it’s because there’s been a real identified need for one specific thing due to a health issue.
About the Author
