What to do when patients don’t stick to treatment plans
Getting patients to stick to their treatment plans after they leave your practice can seem insurmountable. The growing prevalence of chronic and lifestyle diseases means that you’re probably not just advising patients to take their medicine but to make marked changes to their routines and habits. While enormously frustrating for doctors and detrimental to patients, non-compliance could have an impact on practice revenue.
As healthcare moves away from a fee-for-service model to a value-based model, medical professionals will be reimbursed based on patient outcomes. It is important that practices start working more closely with patients now to encourage adherence and better health overall.
While it is ultimately up to the patient to take responsibility for their own health and wellness, medical professionals play a vital role in partnering with the patient to make the best choices and stick to them. There are a few practical strategies that practices can implement to achieve higher levels of compliance to treatment in the short and longer term.
Open lines of communication around treatment plans
There are numerous reasons why patients don’t stick to treatment plans. Forgetting to fill prescriptions or to take medication as prescribed, out-of-pocket expenses, and fear of side effects are just some of the known reasons for non-compliance. Misunderstanding the need for the medicine and a lack of symptoms are also reasons that come into consideration, but all of these reasons can be addressed if the doctor/patient relationship is based on trust and open communication.
While older patients tend to take their doctor’s advice more readily, patients under 40 will usually have more questions about their diagnoses and treatment plans. In short, doctors that engage with patients for the purpose of understanding, are more likely to see patients adhering to their medication and participating in their wellness.
Consider the opportunities you have to open channels of communication with patients before, during and after their consultation.
Outside of consultation, you may want to:
- Establish relationships with key Allied Health Professionals to assist patients to make lifestyle changes;
- Use your practice’s social media pages to share credible, relevant health content;
- Encourage patients to ‘collect data’ by way of written notes and wearables, etc. to review at the next consultation. Because private patients usually have access to their own electronic patient record, consider asking them to input their information as a way to keep them on track and alert you to non-compliance.
- Offer them a route to ask questions, such as by a dedicated email address.
Time is always limited during a consultation, but there are a few practical steps that you can use to maximise both time and adherence:
- Ask patients to take a physical note of complex medication instructions;
- Openly discuss any concerns around the cost of medicines and available generics. Many patients struggle to pay for medicines on an ongoing basis, particularly after medical aid funds have run out. Work with your patient to help them come up with the most sustainable plan.
- Encourage patients to ask questions even after consultation. Patients are sometimes too embarrassed or reluctant to ask questions or simply don’t know what questions to ask. Devote sufficient time to having an open and frank discussion about their treatment plans.
- Consider what digital infrastructure your practice has in place to open lines of communication with patients and keep more accurate patient records that you can access and review in seconds.
Use tech to everyone’s advantage
Patients that work closely with a team of health and wellness professionals led by their doctor have a better chance of making lasting changes. When you combine that with the use of relevant technology, there’s an even bigger chance of success and associate data that can guide further decisions.
Integrating technology as part of your communication can be as simple as automated SMS reminders of follow up appointments or to get repeat prescriptions. If your practice is already using SMS reminders for appointments, why not add medication refills and reminders to that system in a way to improve adherence.
Electronic patient records is another powerful way to use technology for better outcomes. Some EPRs give patients direct access to their records and can input the data you’ve asked them to collect. It also offers a real-time picture of a patient’s health that you can access quickly with the suitable permissions.
There are also a number of clinically relevant mobile apps and wearables that can be used to help patients make changes. Several studies have supported the use of health-related apps to boost medication adherence and compliance to treatment plans. These tools can be used to not only collect data but help guide changes in routine, for example, by reminding your patient to take medication after breakfast.
These tools can be used by almost everybody without the need for training. There are typically free versions of these tools available and patients can participate in their health in ways that don’t require enormous effort. For instance, by consistently using a wearable device a patient could collect information about their sleep patterns without having to write it down everyday.
Look at the data
Generally, patients are considered to be adhering to their treatment regimen if they stick to treatment recommendations 80% of the time. However, it’s estimated that almost 50% of patients never take the medication as prescribed. But is that true for your patient population?
Doctors don’t have control over the accuracy of the information they get from their patients. But if communication is open and the relationship is collaborative, doctors can review patient data to better guide individual patients and tailor their treatment where necessary. Doctors are also able to use the data to see patterns and trends in patient groups with the same condition.
By including data as part of your strategy to improve compliance, you can make information-based decisions about whether to adjust treatment plans to better help the individual. EPRs and digital practice management solutions are a rich source of routine and clinical data that can be tapped into for a number of reasons. Such as: to identify patients who may be are struggling to follow the treatment protocols or to find the most prevalent reasons for non-compliance. It can also be used to determine whether a change in medication or treatment is necessary and to measure whether your effort to improve compliance is working.
It’s also important to choose digital systems to implement that can integrate with medical aid platforms and other key providers, such as pathology and pharmacy platforms. For example, Healthbridge’s myMPS integrates with Discovery’s HealthID that can give you a more detailed picture of the patient’s health, especially if they are a new patient or have a complex medical history.
When it comes to addressing non-compliance with your patients, it’s important to remember that there are numerous tools that can help you provide the best possible care for your patients. Partnering with the right technology partner who understands your business is a crucial step in the right direction. Contact Healthbridge for more information about where you can start to implement successful strategies for your patients and your practice.