Treating By the Clock
Asthma was the first condition to benefit from a little clock watching. Doctors noted that lung function is at its lowest point in the wee hours of the morning, so it would be most ideal for asthma patients to take their bronchodilator medication at this time. However, it is not reasonable to expect someone to wake up at 3 a.m. to pop some pills, so researchers developed long-acting drugs that can be taken before bedtime, yet begin to work much later. One such drug, Uniphyl, is taken only once in the evening but has proven to be a better asthma reducer than more traditional medications, as it acts when the patient is most likely to need it.
"Chronotherapy is the key to [asthma] management," says Dr. Richard Martin, an asthma specialist at National Jewish Center for Immunology and Respiratory Medicine in Denver, in the April 15, 1996 edition of Hospital Practice.
Because asthma symptoms are substantially reduced when taking a drug like Uniphyl, doctors report that patients are more likely to keep using the medication, a major challenge for chronic conditions.
But sometimes, different types of the same condition have different daily patterns, and by recognizing subtle differences, better treatment practices can be implemented. For example, osteoarthritis tends to be most painful in the evening, while rheumatoid arthritis is usually more painful in the morning. Once doctors began to notice these differences, they advised patients with osteoarthritis to take arthritis medications—usually, non-steroidal anti-inflammatory drugs (NSAID)—around noon, but patients with rheumatoid arthritis would be directed to take the same drug in the evening. This way, the medication would kick in at the appropriate time for each condition.
