A farfetched idea? Not if you look at the data. Globally nearly 50% of patients do not take their medication as prescribed. Despite medical advancement in several areas, illness management and outcomes have not improved. Combine this with the fact that particularly patients with chronic illnesses such as diabetes and hypertension suffer from the effects of non-adherence – the rise in costs, healthcare complications and morbidity may only be the tip of the iceberg.
The World Health Organisation has outlined “increased effectiveness of adherence interventions” a far more successful tool to improve global health outcomes than any medical advancement (WHO, 2003) – so how do we achieve this?
The first step is generating awareness. “There is still a great lack of awareness around non-adherence to medication,” says John Weinman – Professor of Psychology as applied to Medicines at King’s College London – and chair of- and presenter at the congress, “healthcare professionals are not seeing the scale of the problem and how they themselves are best equipped to target the issue during routine consultation. They can make a real difference.”
Secondly, the tools to address adherence issues with patients during routine consultation need to be easy and effective. “We need to develop much more sophisticated interventions in order to apply behavioural change techniques successfully,” Weinman states. Even when healthcare professionals are aware of issues, packed waiting rooms and short consultation slots often determine outcomes.
Last, healthcare professionals need to work with their patients, not just tell them what to do. “We need to take a patient centred approach,” states Atul Pathak Professor of Medicine and the Head of the Department of Cardiovascular Medicine at the Princess Grace Hospital in Monaco, “we need to plan, organise, identify patient’s willingness and readiness to change and we need to change our own behaviour towards the patient. We are equal partners.” Patients, like all of us, are complex human beings that need time to adjust, gain motivation and come to terms with medical diagnosis and treatment. “We need to tailor the advice to the patient,” states Dr Sheri Pruitt, Principal and Founder of Evidence Based Answers, LLC, “start small and don’t tell patients what to do – ask open ended questions and use their emotions and values to increase adherence to medical advice.”
In short, with the right behavioural science, we can not only change the way we approach the patient – the awareness we have around their adherence to medication and the tools and techniques we use to address potential issues - but can ultimately achieve better health outcomes. This could have a major impact on the quality of life of the individual, health care systems as a whole and generate a global boost in improved health outcomes.