Capstone students Brienne Seekford, Andrew Whipkey and Kristin Latessa, will present a seminar entitled, "A Discussion on Patient Compliance," next Friday (October 21st). Links to four separate background readings have been provided on the Seminar Schedule page.
Thursday, October 13, 2016
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This presentation discussed the relationships between doctors and patients the issue of noncompliance, where instructions from the doctor about treatments are not followed efficiently, if at all, by the patients. The students talked about potential causes of noncompliance in patients, such as cultural factors, communication issues with the doctor, lack of education about their health condition and financial issues. Solutions could include seminars for doctors (to improve communication skills with patients), reminders about treatments and/or taking medications, and MEMS monitoring. This is an important issue, as many individuals struggle with their health and have financial troubles due to noncompliance. What other solutions do you all think would be effective on helping to solve this issue? Do you think there is one approach that could be applied to all situations of noncompliance, or does there have to be separate approaches depending on the situation? Or could it be both?
ReplyDeleteI worked in an assisted living home for three years so I know first-hand how frustrating noncompliance can be. It was especially frustrating for me because I was a medication technician and was directly responsible for ensuring the residents were being administered their medication as per their doctor's orders. If they refused a dose of a particular medication or treatment, I had to document it. I think one tactic that seemed to get the residents to understand the importance of their compliance was to explain what happens when they don't take their medication. Show them how their actions affect their progress, like tracking their nutrition and how it affects their weight gain. I also think it depends on each individual case how you approach the noncompliance issue, as there are many different reasons why people don't comply with doctor's orders.
DeleteDue to the problem of compliance are determined by a wide range of differing circumstances I do not believe there could be one approach to solve the issue. The solutions that were discussed during the presentation is a good start. But, there will always be other problems associated with compliance. For example, some people do not understand their condition or treatment, some people cannot afford the treatment, some people due to cultural differences feel that they cannot comply with the treatment.
ReplyDeleteThere is definitely not one solution to completely fix noncompliance across the board. Patients are noncompliant for a host of reasons.
ReplyDeleteBut I think the most important step we can take in improving compliance would be training doctors to better connect with their patients. Doctors should be able to communicate with their patients in such a way that the patient feels respected, safe, and heard.
One of my biggest struggles with my doctors when I was seeking my own diagnosis was that my doctors rarely seemed to take my input into account. It's not a good experience as a patient and it breaks the doctor-patient trust.
Noncompliance does not have one solid answer. Especially when it comes to financial reasons. But it should go without saying that doctors need to be able to better educate and communicate with their patients.
The three undergraduate presenters did an excellent job in explaining the problem of patient compliance. I agree with some of their solutions to this dilemma, but as with other various issues, there is not a single solution to this problem. I think that many patients have “white coat syndrome” meaning that they irrationally fear what the doctor might think of them if they explain their ailment in its entirety. To try to reduce this, clinicians, as well as those that employ them, should focus on proper interpersonal skills that go along with any profession that works with the public.
ReplyDeleteDue to the many different problems that arise for noncompliance, such as on the doctor lack of communication, financial instability of patients, cultural beliefs, etc., I do not believe there is a single solution to solving the noncompliance issue. I think that different situations require different approaches. On the doctor aspect of things, I think doctors need to learn proper communication skills for when they interact with patients. Doctors need to educate their patients on the medications they prescribe and how that medicine will help them, as well as the complications that may arise if a patient does not take the medication as directed. On the patient side of things, I think patients need to ask questions when they are confused or need help. I understand people who may have the “white coat syndrome” as John mentioned, however, doctors are educators. Their main job is to educate their patients on health and wellness and many doctors that I know love sharing their knowledge and educating patients so that they do not become misinformed. Granted, not every doctor is like that, so that is where proper communication skills become the key focus on their end.
ReplyDeleteFamily support could help with the issue of patient noncompliance. A catch-all phrase could be provisions to assure clarity of diagnosis and treatment. I think a broader principle or concept could provide a framework for personalized solutions to each instance of noncompliance.
ReplyDeleteThere is no single approach that can be used to all noncompliance situations. Each situation has its own way to deal with at different levels. Doctors on the other hand should be well trained on how to deal with patients. Being able to read the psychology of the patients will help alot in the questions to pose to patients and the patient will be frankly in answering. Thus doctors with good communication skills can greatly have a positive relationship with their patients, and the patients will build trust hence be much more comfortable.
ReplyDeletei think, the issue on "patient compliance" need a deep search especially on patient background and belief aspects. some patients feel emotionally intimidated once they disclose their condition. however, right approach to the patient may lead to the disclose of their health information for the betterment of diagnosis and treatment.
ReplyDeleteI think this problem has to be addressed from multiple areas in order to effectively combat it. The physicians should and do spend time explaining the treatment so the patients have an understanding of the ailment and how the treatment is helping. However, I would imagine that most patients don’t actually grasp what is being told them or understand why certain treatments are/aren’t options for them. This can put a strain on the relationship and cause the patient stop placing value into the physician’s treatment plan. Another area to be addressed is the cost of medication and treatments. The presentation discussed how many patients won’t comply because cost of their medicine is too high. These high prices are the result of pharmaceutical companies making huge profits off their products. More regulation should be imposed to limit how much a company can profit with respect to the cost and manufacturing of the drug. These are only two parts of the overall problem and many more areas must be addressed in order to correct it.
ReplyDeletePatient compliance needs to be taken care of from different aspects. Diversifying a medical office and hospitals would more likely to break the cultural and ethnic barrier. Physicians need to spend more time with patients to build a rapport with them so that it becomes easier for patients to choose their treatment plan and also they can trust their physician.
ReplyDeleteUnderstanding and effectively informing are two important aspects to help overcome the issue of patient compliance. Many people shy away from following what they are instructed to do just from ignorance or misunderstandings of importance. As a patient seeking medical help, they should understand the need to follow treatments and certain procedures even though they might not feel comfortable with it. If the importance is clearly explained, it will help them to further go through with the medical plan. This is why both the patient and the doctor need to have good communication. Diversifying the types of doctors as well as providing courses for doctors to take on communication and background understanding will help patient compliance, too. Working with doctors, I have seen caring doctors as well as doctors who treat their work as a straightforward job where they don’t see the patients as human beings. In my opinion, doctors are not properly doing their job if they do not try to understand the patient and their background. This can range from culture to religion to just social life situations. Family/friends’ support is necessary, too, just because hearing things from people close and familiar to you will increase motivation. Regardless of all different approaches that may be taken, there will always be patients who will not comply. At that point, doctors can at least say they tried their best. The amount of patient noncompliance will hopefully slowly diminish with these techniques.
ReplyDeleteIn the inpatient setting, mental health problems and lack of regimen commitment (often due to indifference) seem to be enormously driving of non-compliance. Outpatient settings are likely different. Biopsychosocial model.
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