Managing Hypertension Medications for Foreign Workers in Taiwan

Blood Pressure Medication Inquiry for Foreigners

I would like to ask: Due to work-related matters, I have been assisting Japanese individuals who are coming to Taiwan for long-term work with their daily living affairs.
During this period, I helped a 50-year-old man who has been taking antihypertensive medication for over ten years to visit a clinic.
He had run out of the medication he brought from Japan and asked me to assist him in communicating with the doctor that he did not need the exact same medication, just something to manage his blood pressure.
I explained the situation to the doctor accurately.

During the first visit to the clinic, the doctor noticed that the patient was taking more than one type of antihypertensive medication and referred to a medication guide to compare available options, noting that while we had similar medications, they were not identical, and he could only prescribe two types.
(The patient was actually taking 4 to 6 different medications daily in Japan.)
On the second visit, the patient mentioned that one of his medications in Japan is taken as two tablets (but the Taiwanese doctor said to take one tablet).
The doctor's reaction was somewhat strong, and he immediately responded that if we trust Japanese doctors more, we should get the medication in Japan.
He then asked me when this Japanese worker would return to Japan, suggesting that if he was going back, he should just take his Japanese medication, and that he would no longer have any connection with him afterward.

I would like to ask: 1.
Does the difference in countries and environments lead to different medication regimens? 2.
Should I directly inform the patient to ensure he brings enough medication when he returns to his home country? Please advise.

chung, 30~39 year old female. Ask Date: 2018/05/21

Dr. He Dongjin reply Cardiology

Hello, 1.
Let's change the doctor.
2.
It doesn't matter whether it's a black cat or a white cat, as long as it catches mice, it's a good cat.
What you eat is not important; the key is whether your blood pressure is under control.
Regardless of whether it's Chinese or Western cuisine, you should always be able to eat enough.
Blood pressure may vary in different countries and environments, and medication may also differ.
However, it is advisable to bring your blood pressure records to your doctor for review, so they can adjust your medication if necessary.
If different medications or dosages cause anxiety for the patient, it is best to inform them to ensure they have the necessary medications prepared when they return to their home country.
Changhua Hospital cares about you.

Reply Date: 2018/05/21

More Info

Managing hypertension medications for expatriates, particularly for individuals who have been on long-term treatment, can be quite challenging, especially when they are in a foreign country like Taiwan. The case you presented involves a 50-year-old Japanese man who has been taking multiple antihypertensive medications for over a decade. He has run out of his prescribed medications and is seeking alternatives in Taiwan. Here are some important considerations and recommendations regarding this situation.

1. Differences in Medication Practices Across Countries
Indeed, medication practices can vary significantly from one country to another due to differences in healthcare systems, available medications, and prescribing guidelines. In Japan, the patient may have been prescribed a specific regimen that includes multiple medications at different dosages. However, in Taiwan, the physician may have limited options due to formulary restrictions or differences in the availability of certain drugs. This can lead to discrepancies in treatment plans, as seen in your case where the Taiwanese physician suggested a different dosage than what the patient was accustomed to.

It's essential to recognize that while the underlying principles of managing hypertension remain consistent, the specific medications and their dosages may differ based on local practices and the physician's clinical judgment. Therefore, it is crucial for the patient to communicate openly with healthcare providers in Taiwan about their previous treatment history and current needs.

2. Importance of Continuity of Care
Given that the patient has been on antihypertensive medications for a long time, continuity of care is vital. It is advisable for the patient to maintain a consistent medication regimen to avoid fluctuations in blood pressure, which can lead to complications. If the patient is returning to Japan soon, it would be prudent to ensure that they have an adequate supply of their medications before leaving Taiwan. This could involve:
- Consulting with the Japanese physician: The patient should reach out to their healthcare provider in Japan to discuss their current treatment plan and any necessary adjustments that may need to be made based on their experience in Taiwan.

- Obtaining a prescription in Taiwan: If the patient is unable to get the exact medications they were taking, the physician in Taiwan should work to find suitable alternatives that can effectively manage the patient's blood pressure. This may involve prescribing different medications that are available in Taiwan but may not be the same as those used in Japan.

3. Patient Education and Communication
It is essential to educate the patient about the importance of adhering to the prescribed treatment plan, even if it differs from what they are used to. The patient should be informed about:
- Potential side effects: Different medications may have varying side effects, and the patient should be aware of what to expect.

- Monitoring blood pressure: The patient should be encouraged to monitor their blood pressure regularly to ensure that it remains within the target range. This is particularly important when transitioning to new medications.

- Emergency contacts: The patient should know how to seek medical help in Taiwan if they experience any adverse effects or if their blood pressure remains uncontrolled.

4. Recommendations for Future Medication Management
In conclusion, it is advisable to inform the patient to prepare adequately for their return to Japan by ensuring they have enough medication to last until they can see their physician there. Additionally, they should be encouraged to maintain open communication with both their Taiwanese and Japanese healthcare providers to ensure a smooth transition and continuity of care.

In summary, managing hypertension medications for expatriates requires careful consideration of the differences in healthcare practices, the importance of continuity of care, and effective communication between the patient and healthcare providers. By taking these steps, you can help ensure that the patient receives the appropriate care they need while navigating the complexities of medication management in a foreign country.

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