How to Assess Adherence to Medical Treatment Regimens
This guest post was authored by Kimberly Driscoll, Ph.D. Dr. Driscoll is licensed clinical psychologist specializing in the use of technology to improve patient adherence and is a member of the PRAXIS Advisory Board.
I have often heard family members, medical students and even providers say that patients “should just do what they need to do to manage their disease.” This is nice in theory; however, decades of research and clinical practice have shown that many patients are unable or unwilling to adhere to their treatment regimens. In fact, 30% of patients fail to adhere to short-term regimens such as antibiotics; 50% of pediatric and adult patients do not adhere to treatments for chronic conditions; and 75% of people are not able to engage in lifestyle changes (e.g., diet, exercise).
The reasons vary from volitional nonadherence (e.g., refusal, adherence holidays, avoidance of negative side effects) to unintentional adherence (e.g., forgetting, inadequate knowledge and skills). In addition, some patients are unable to adhere because of financial problems.
Importantly, one understudied and underappreciated reason for lack of adherence is patient-provider miscommunication. Some studies have demonstrated that providers recall far more information that they think they provided to patients, whereas patients recall very little, and the overlap is surprisingly low.
There are many “Do’s and Don’ts” that can be used to encourage adherence, and as you might expect, threatening patients with negative health consequences (and even death) is not one of them! Take a look at the graphic on the right; are these approaches you are using successfully with your patients? Let us know in the comments!
For those interested in learning more about adherence, please also see: Patient Adherence to Medical Treatment Regimens: Bridging the Gap Between Behavioral Science and Biomedicine (Current Perspectives in Psychology) by Alan J. Christensen.