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Adherence to treatment: why do some patients leave?

Adherence to treatment: why do some patients leave?

November 27, 2021

When implementing psychological or pharmacological treatments, not everything depends on the experience and the willpower of doctors or psychologists. In fact, there is a potential problem capable of making the whole plan to reach the cure or the remission of symptoms fail: the lack of adherence to treatment.

The truth is that many times the improvement of patients' health is interrupted (or does not start) because they decide to leave the intervention program, or only partially comply, for example, forgetting to take his pills very often or not practicing the technique of exposure in case you want to control a phobia.

However… what we know about adherence to treatments and to what extent can you promote the non-abandonment of these?

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Why it is important not to abandon the treatment

Given certain medical problems it is important to follow the treatment in a disciplined way if you do not want to risk serious damage to your health, or even death. However, even if the consequences do not have to be serious, the lack of adherence to treatment it always produces negative consequences . The main ones are the following:

Increase in health expenditure

The resources, efforts and the time that is invested in initiating a psychological or medical treatment are wasted if the health improvement program is abandoned.

Subjective discomfort

Although some diseases and disorders disappear or remit without intervention, in many cases the lack of adherence directly generates an increase in discomfort or, directly, there is no improvement.

Appearance of idea of ​​inefficiency

Some patients they interpret the abandonment of treatment as a failure of this , which means that the negative sensations that they experience later because of the lack of palliative or curative measures are perceived as ineffective on the part of the health team.

Is the lack of adherence to treatment common?

As far as is known from the numerous investigations carried out on this subject, the lack of adherence to treatments is one of the serious problems that must be faced by any health system.

In fact, about half of people with disorders and chronic diseases decide to stop treatment or forget about it. Further, almost three quarters of people stop following preventive programs , and almost a third of people with non-chronic health or psychological problems do the same with measures designed to improve their condition.

The profile of the people most likely to leave treatment is that of someone with a chronic problem who must make significant changes in their lifestyle. For example, someone with Bipolar Disorder who has been recommended, among other things, to create a diary and to think about how to manage their personal relationships better in the mornings and afternoons.

The opposite occurs in those people who, in the face of an acute health problem or a specific psychological crisis, must assist the clinician to directly apply the treatment. This tendency to do not stop collaborating with the health program It is greater if the improvement of the symptoms occurs quickly.

How to make patients commit?

These are some measures that have been shown to be effective in avoiding a lack of adherence to treatment:

1. Constant communication

The therapist-patient relationship must be fluid and based on good rapport. This means that any doubt must be resolved and that we must leave room for the patient to raise their questions and express their insecurities.

  • Related article: "The Rapport: 5 keys to create an environment of trust"

2. Offer an individualized treatment

To prevent problems that may arise, it is necessary to know, even in a superficial way, what each patient's way of life is, and their beliefs or beliefs. level of knowledge about your problem . For example, if there are prejudices in your home against drug-based treatments.

3. Start the treatment along with another desirable habit

To make the change be perceived as something positive, it is possible associate it with a better lifestyle and healthier in the eyes of each patient. For example, the same day you take the first pill, start with a much healthier diet and designed to improve the general health.

This, in addition, allows to create a compensatory mechanism . For example, someone who believes that taking a capsule in the morning will not produce great effects can interpret it as part of the routine that involves starting drinking a glass of water, or you can understand that it is a proposal of healing that is combined with another which is better tolerated, covering all fronts of health intervention. In this way, a global improvement is used, without leaving blind spots.

4. Motivate through other mechanisms

In certain special contexts it is possible to use programs to reinforce adherence to treatment. For example, the use of chip economy, which can be used at home, in schools or hospitals.

Current State of Medication Adherence: Challenges and Solutions (November 2021).

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