General

SIMPLE strategies to increase patient compliance

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19 Jul 2016 - General
 

I’m sure you have encountered the hard-headed patient. No matter what explanation you give, they only seem to follow up when their health condition has deteriorated already. Non-compliance to treatment follow up, medication adherence and lifestyle changes is an important concern that doctors need to do something about. I encountered this journal that advocates ways to increase compliance using the mnemonic “SIMPLE”

Simplifying regimen characteristics

Decreasing dose frequency by using a longer acting medication increases adherence to the medication regimen. This is particularly useful for the elderly population who commonly forgets to take medications and for those who live a very busy lifestyle. It’s also important to make sure that frequency matches the lifestyle of the patient.

Imparting knowledge

This is actually basic. Physicians should spend time explaining a patient’s health condition and the rationale for each medication that is prescribed. Patient adherence to medication will improve if they are aware of its benefits to their health. Informing them of common side effects may potentially improve clinic follow-ups because they are aware what to watch out for.

Modifying patient beliefs

More often than not, patients cope with medical illness by denying the gravity of the situation. Doctors should take time to explain how serious their medical condition is and what should be done. Doctors should be also ready to recognize patient anxiety, fear and negative emotions related to their health condition. These issues needs to be addressed to improve patient perception on medical treatment.

Patient communication

Its important to establish rapport to gain the trust of our patients. If a good patient-doctor relationship is established, this will definitely improve compliance to treatment and follow up. 

Leaving the bias

Studies show that there is no association between compliance to treatment and specific demographic factors such as race, gender, intelligence, educational attainment, marital status, occupation, income and cultural background. Healthcare professionals should maintain standard interactions with all patients.

Evaluating adherence

Here are four questions that is recommended to assess adherence to medications. 1) Do you ever forget to take your medications? 2) Are you careless at times about taking medications?
3) When you feel better, do you sometimes stop taking medications? 4) Sometimes, when you feel worse, do you stop taking your medicine? If there is a compliance issue, doctors should determine the reasons why and create a plan of action based on these assessments.

In your medical practice, do you have other techniques that may increase patient compliance and to which subset of patients are these recommendations effective?

@Ziwei: Like Priscilla mentioned, in our outpatient setting, the job description of pharmacists would be limited to dispensing the prescribed medication. Among those confined to the hospital, clinical pharmacists can make suggestions with regards to dose, frequency and even the medication itself if there are drug interactions. However, its still the physician who will prescribe the dose, frequency and form. It is quite taxing but we've been trained to always check the patient's medicatio...
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"frequency matches the lifestyle of the patient"- I completely and utterly agree with this. We do not need to be so rigid in the prescription of medicine and how they should be taken. If the patient's work schedule won't make them compliant, adjust! This is also quite important in pediatric patients. Though the teacher is there in school to help the child with his/her medicine it is difficult to disrupt class to do so. Best stick regimens for children at BID or if TID at least ...
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Imparting knowledge should be given great emphasis to the compliance of this non compliant/ forgetful patients. In our setting, pharmacist don't give the instructions to patients. Nurses are doing everything from bedside care up to discharge medications and prescriptions. Having a responsible folks along the patient is also a plus most especially to geriartic patients. It could have been better if the pharmacists from each institution must give the health teachings on drug compliance aside f...
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Now that is why we need a pharmacist. Will any doctor do all the steps above although we know that is exactly what we need especially when we are dealing with polypharmacy in geriatric patients. I have seen patients who come to my clinic with 2 large shopping bags of medication and asked me which one is she suppose to be taking for her chronic disease. Sorting out the medications themselves, explaining the lab result, providing dietary advice and answering their " by the way "questions...
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