Improving Adherence: Who's Doing the Work?
- Approximately 50% of patients with chronic illnesses are not adherent to indicated medications, treatment regimens, and healthy lifestyle changes, which can lead to increased morbidity, excess mortality, and tremendous cost.
- Nonadherence is a challenging problem for clinicians because of the myriad barriers that may contribute and the many complexities of human behavior involved.
- Barriers to adherence can be patient-related, physician-related, and system- or health team-related.
- Physicians should be aware that adherence in one behavioral realm does not mean that a patient is adherent to other aspects of a treatment regimen.
- Motivational interviewing is a one approach to improve adherence in individuals struggling with behavior change.
- Reflective statements can be used to emphasize content, emotion, both sides of the discrepancy, or an alternative way to frame what the patient has said.
- Behavioral research demonstrates that patient motivation is a dynamic state that is influenced by the interviewer's style.
& Hershberger, P.
(2014). Improving Adherence: Who's Doing the Work?. Primary Care Reports, 20 (1).