What is medical adherence?
Adherence, also called compliance or concordance, refers to the extent to which a person follows the instructions they are given for prescribed treatments. This includes taking medications correctly and on schedule, keeping follow-up appointments, making lifestyle changes recommended by their doctor, and completing rehabilitation programs. Medical adherence is crucial for treatment effectiveness and positive health outcomes.
Factors impactingadherence
Several factors can negatively impact a patient’s ability or willingness to adhere to their prescribed medical treatment. Understanding these factors is key to improving adherence.
Complexity of treatment regimen
The more complex or demanding a treatment plan, the harder it is for patients to follow exactly as instructed. Regimens with multiple daily doses or lifestyle changes compete with busy schedules and can be easy to forget. Simpler, more flexible dosing schedules tend to see better adherence.
Cost of treatment
Financial barriers like high medication costs, transport to appointments, and time off work negatively influence adherence. Many cannot afford the out-of-pocket costs for their care. Finding ways to lower costs or provide financial assistance can help overcome this barrier.
Mental health issues
Medical conditions like depression, anxiety, schizophrenia and substance use disorders commonly co-occur with physical illnesses. Their symptoms like poor concentration, lack of motivation, and forgetfulness sabotage a patient’s ability to remember and prioritize their medical care. Treating any underlying mental health issues is important.
Lack of understanding or misperceptions
Patients may not understand complex medical information, their condition, why certain treatments are necessary, or how non-adherence risks their health. Misperceptions about side effects or unrealistic expectations can also discourage following instructions. Clear, repeated education from providers is key.
Poor provider-patient relationship
If a patient feels disrespected, that their concerns are dismissed, or cannot communicate effectively with their provider, it damages trust and the likelihood they will closely follow medical advice. Providers must show empathy, answer questions thoroughly and gain buy-in for the treatment approach.
Strategies to improve medical adherence
Once the challenges to adherence are better understood, coordinated efforts are needed across the healthcare system, providers, patients and community groups to support patients and facilitate consistent medical management.
Use of adherence aids and simplified regimens
New technologies and dosing methods make it easier for patients to stick to regimens. This includes pill organizers and reminders, home blood pressure monitors, inhaled vs oral medications, long-acting injectables, and implanted devices. Simpler regimens are preferred when clinically safe.
Education and counseling
Ongoing education helps awareness and understanding of conditions and builds self-management skills. Counseling identifies personal barriers, builds motivation and problem-solves challenges through goal-setting. Teaching warning signs, when to seek help and reinforcing importance of adherence positively impacts long-term habits.
Social and community support systems
Support groups, buddying programs, nutrition/exercise classes, reminder phone calls and home visits from community health workers extend providers’ influence and promote accountability. Support networks mitigate feelings of isolation and alienation that undermine self-care.
Integrating medical and behavioral care
Co-located or consulting services address mental health, substance use, social determinants of health, health literacy and lifestyle factors alongside physical treatment. This comprehensive approach achieves synergies across conditions and better addresses root causes of non-adherence.
Use of digital tools and telehealth
Mobile apps, remote monitoring devices, electronic medication packagers, web portals and two-way telehealth allow real-time data monitoring. They provide automated care plan reminders, motivational messaging and early alerts when adherence lapses occur so issues can be quickly addressed. Digital addiction further engages technology-comfortable generations.
Overall ensuring medical adherence requires the healthcare sector, communities and patients working together with a multi-pronged approach tailored to individuals’ needs and strengths. Improved compliance benefits healthcare costs, clinical outcomes and quality of life. Prioritizing adherence builds a healthier society.
