Enhancing Patient Adherence: Strategies and Interventions
Strategies for Improving Patient Compliance
General strategies to facilitate compliance: Instruct and educate patients to improve their knowledge and responsibility regarding prescriptions. Supervise, remember, and reinforce treatment choices. Permit complex therapeutic modalities. Divide treatment into steps, simplifying the duration and complexity. Involve family, social circles, and couples. Ensure sound management of communication by the healthcare professional. Encourage self-registration. Adapt treatment patterns to the patient. Restructure daily habits and the organization of care.
Attitudes and Behaviors Affecting Adherence
Attitudes and behaviors that the healthcare provider (HCP) should avoid or incorporate to promote adherence:
Attitudes and Behaviors That Interfere with Adherence:
- Consider the patient as merely a taxpayer, limiting recommendations.
- Believing that whether the patient takes medication or not is not your problem.
- Treating the role of the HCP as solely to treat and cure the disease.
- Believing that medication is the only cure.
- Saying that a cure is not possible or not doing anything different from what was learned.
- Believing that anyone can be paid to do patient education or prevention.
Attitudes and Behaviors That Facilitate Adherence:
- Introduce yourself.
- Address the patient’s concerns, fears, doubts, expectations, and goals.
- Answer all the patient’s questions.
- Use vocabulary appropriate for the patient. Avoid jargon and technical terms.
- Explain the advantages and disadvantages of treatments.
- Be cordial and concerned about the person.
- Understand patient preferences and seek suggestions for reaching therapeutic agreement.
Communication Strategies for Promoting Adherence
Communication conditions that promote adherence: Submit the message in an intelligible form and avoid jargon. Provide basic health concepts. Illustrate information with examples relevant to the patient. Request feedback. Emphasize the importance of the message. Use short words and phrases. Show a close and friendly attitude. Use two-way communication methods.
Psychosocial Interventions for Adherence
Psychosocial intervention on adherence:
- Signaling techniques: Very valid in complicated medication regimens, multidose vaccines, etc.
- Techniques of self-control: Measured blood pressure, glucose levels, etc.
- Operant conditioning techniques: Prevention, improvement, or maintenance of adherence.
Preventive Strategies:
- Facilitate the patient’s attendance at appointments: reminders.
- Provide detailed, simple, and relevant information.
- Ensure the patient understands.
- Reduce aversive or feared aspects of the situation by minimizing delays and providing affectionate treatment.
- Detect subjects prone to failure.
Improved Strategies:
- Signs and visible reminders in key places.
- Increasing the enjoyable aspects of improvement.
- Combining systemic treatments.
- Using simple calendars and watches with alarms, notes on medication containers.
- Adapting treatment to the patient’s lifestyle.
- Implementing treatment in stages if possible.
- Utilizing family and friends to strengthen the patient’s commitment.
Maintenance Strategies:
- Highlighting the negative consequences of non-compliance.
- Fostering self-monitoring by the patient.
- Anticipating feelings of satiety or fatigue.
- Encouraging collaboration and control within the family.
- Supervising successes and failures.
Methods for Evaluating Adherence
Evaluating patient adherence: Different methods can be used to assess a patient’s adherence (self-report, reports from people close to the patient, self-registration, drug measurement, remaining analytics, etc.). No single method provides sufficiently reliable information on its own. Therefore, the most reliable method seems to be using more than one simultaneously.