Patient adherence

[Emilia Khalil]

Patient adherence is one of the major concerns and challenges we face as care providers. It is enlightening to think of adherence as a collaboration between the patient and the physician to improve the patient’s health by integrating the physician’s medical opinion and the patient’s lifestyle, values and preferences for care. To be able to put that concept into perspective, adherence is a combined effort between patients and care providers and mutual efforts to use multiple strategies to improve adherence is a responsibility on both parties. Since illness-relevant cognitions, perceptions of disease factors, and beliefs about treatment have a strong relationship to adherence, these are areas that can be nurtured to improve adherence. Chronic illnesses are more difficult to manage and achieve adherence, this is where the patient-physician interaction plays the utmost role through discussion and mutual understanding of patient’s needs and beliefs.

[Hibah Ismail]

Patient’s adherence is an extremely important aspect in the patient’s health and can affect the health system in whole. However, many aspects can stand in the way of 100% adherence, and it is our duty as healthcare providers to search for causes of non-adherence and try to resolve them with our patients. Some examples can be patients having difficulty obtaining transportation to appointments or pharmacy, not being able to afford cost of medications, having side effects from medications, forgetting some doses, ect. This causes improper treatment of diseases, increased hospitalization and an overall decline in the efficacy of the healthcare system in general. Therefore searching for the underlying cause of patient’s non-adherence and developing optimal patient-physician relationship while including patients in their own treatment plans is crucial for a better healthcare system.

[Ali Saker]

Strategies and skills that I have been trying to acquire during the last year to improve my patient’s medications adherence includes:
Allowing them to feel that they are actively participating in their treatment, asking them open ended questions , offering options, avoiding BID/TID medications if possible, and avoiding one sided decisions as much as possible.
Something I have learned this clinic week is that we can prescribe pill boxes on nextgen, which simplify complex drug regimen, also I learned that we are able to arrange home nurse aid to help putting the medications in the pill boxes for those who can not do it themselves. One observation I have personally noticed in non-adherent patients, is that letting them know that my role is to offer advice only, and reminding them about their ownership of the decisions regarding what they want to introduce to their bodies, avoiding paternalistic comments, all have yielded a positive outcome on their following appointments.

[Khaled Janom]

It is imperative to address the psycho-social reasons that contribute to patients’ non-adherence to medication regimens. Other factors include cost, side effects, transportation, pharmacy access, home status… among other things.

[Brett Trzcinski]

Very useful readings and discussion on patient adherence this week. The take-aways that I will implement in my practice going forward are: avoiding BID and TID regimens when possible, prescribing pill organizers, and taking more time in my encounters for patients to “teach-back” their medication regimens. I look forward to utilizing these helpful tips as well as our future cohort social determinants discussions.

[asil daoud]

Successful treatment of disease with prescription medicines requires consistent use of the medicines as prescribed. Nonadherence to medicines is a major health care cost and quality problem. Improving adherence by exploring obstacles on patient’s side, and more education holds great potential to contribute to better health outcomes and more effective chronic care management.

[Amir Laktineh]

When it comes to health risks, failure to take prescribed medications, also known as nonadherence is doing more harm to the health of patients than other know risk factors like poor diets, lack of exercise, or even smoking. Many simple yet important strategies have been proved to improve patient’s adherence such as education, simplifying regimens and most importantly social support to remind them of what needs to be done amongst other things such as transportation.

[Mohammad Talha Rauf]

As I board my airplane overseas I am reflecting about adherence. We should stop calling it non compliant some call it adherence very important our

[Arslan Mahmood]

This week’s discussion on patient adherence was very enlightening. Our job does not end at prescribing the medications. We should address the importance of patient adherence to these medications. An extra 10 min counseling on this aspect can play a huge role in reducing readmissions to the hospital and decrease ED visits.

[Nabeel Rizvi]

Our discussion this week provided an excellent opportunity to look at the many reasons for patient medication non adherence. We were able to discuss a number of strategies to help improve medication adherence within the limits of our clinic practice. Here are some of the things I took away from our discussion to circumvent non adherence –
1. Understand common reasons why patients might avoid taking their medications – often times this could be fear, worry or mistrust of the Physician, lack of symptoms, depression, cost or total number of medications being taken.
2. Maintain a positive attitude when asking about non adherence.
3. Account for your patient’s belief system. When educating a patient on the importance of medication adherence, consider where they are in their journey with a disease and condition, their beliefs and interests, and their specific needs.
4. Develop a patient-centered approach to combating non adherence. Each person has unique health needs and it is essential for us to engage patients in their health and healthcare by asking what challenges they may face.
We came to the conclusion that patient adherence should be a multidisciplinary approach that needs to be carried out with the support of all those who are involved in medication use.

[Alaa Akhras]

I feel that most of the patients that arrive to the clinic for acute issues usually display some form of non-adherence. It is important for us as physicians to get to the root cause of the reason as to why our patients are non-adherent to their medication or their required lifestyle modifications including fluid restrictions, diet, exercise, etc. I feel that one of the main reasons that non-adherence is such a big issues is secondary to us as physician not giving the proper education or proper follow up for how to use their medications and how impactful these medications can be for their long term care. Also we have to figure out why they are not taking the medications. Is it because of a lack of insurance? Is it because of forgetting? Is it because ofa lack of access to obtain these meds? These are all questions we mus ask in order for us to become good physicians and to help with the issue of non-adherence.

[Author]

Posts