Medical adherence, not to be confused with compliance, is an active involvement in the betterment of one’s health through actionable changes. Compliance, on the other hand, is a passive involvement in one’s wellness journey. Compliance also implies that the individual does not have much control as opposed to adherence, where the individual is in the driver’s seat of their own healthcare. Adherence can have a significant affect on an individual’s prognosis, however adherence may not be enacted. In a study conducted by the World Health Organization (WHO) in 2003, researchers found that in developed countries, 50% of individuals with chronic health conditions adhere to their providers recommendations and therapies for certain health conditions. This statistic is further compounded when faced with other factors and barriers to healthcare adherence discussed in this month’s blog post.
Understanding the recommendation
According to a study looking at English and Spanish- speakers, several individuals misunderstood the directions and recommendations from their physician. Factors contributing to this confusion was language, comprehension of the medical jargon (even if instructions were given in their native language), and age. Several other studies have shown that when given verbal instructions, patients struggle to recall the information at a later time, especially when the physician uses medical jargon. The resulting issues led patients to erroneously take their medication, which could potentially effect the therapeutic value of the medication. Furthermore, the lack of medicinal effect can lead to depression and feelings of hopelessness.
Our clinician’s recommendations:
It definitely can be intimidating when an authority figure is throwing information in what seems like a hefty pile. However, we may forget that we are the authorities of our bodies and we deserve to give ourselves a moment to check in with the information we are getting. I often recommend clients to request a follow-up document, whether their physician uses an Electronic Health Records (EHR) software or can give you a print out at the end of your visit. Sometimes, physicians may not use these methods, so I often recommend clients to take notes either with old school: pen and paper or using their notes application on their phone. Another component to ensuring optimal understanding, maybe requesting a provider who speaks your native language (if that option is available) so nothing is lost in translation, and asking your physician questions to make sure you understand (“If I understand you correctly,…” or “I just want to make sure I got this right,…” are some starters).
The rapport with the PHYSICIAN
It is no surprise that “bedside manners” effect adherence. Research has found that physicians who foster a therapeutic environment through effective communication and support led patients to be more actively involved in their treatment process. The more active patients are in their treatment, the more they are satisfied with their partnership with their provider, and the more cohesive partnership led to better adherence. Another study found that it is imperative that patients feel comfortable with their physician, to ensure that all the important information is shared with the provider. It is also important to have all the needed information for the physician to make an accurate recommendation.
Our clinicans recommendations:
When buying a car, we shop around until we find the car that meets our needs, because this is a decision that can potentially affect us in several areas of our lives (financially, commute, enjoyment, etc.). The same goes for finding the right provider. If you are able to meet with different providers in your area, it is ok to make sure they are a right fit for you. Your healthcare is a partnership, and you can decide if the provider’s style fits with your needs.
Interesting studies
https://pubmed.ncbi.nlm.nih.gov/7474271/
https://pubmed.ncbi.nlm.nih.gov/15096368/
https://pubmed.ncbi.nlm.nih.gov/11841530/
https://pubmed.ncbi.nlm.nih.gov/15893213/
Stayed tuned for Part II where we discuss culture and psychological factors to adherence and Part III where we explore how medical adherence affects chronic illness.
This month’s blog post was written by our Chronic Illness specialist, Aarti Felder.
Contact us for more information or assistance in managing your chronic illness.