Entry id
1_aycioubw
Managing Adherence and Persistence in the Clinic
The way I look at persistence and adherence to medications, I think I would look at it in two aspects. You have persistent adherence to medication early on, and you have persistent adherence to medications that you're giving your patient long-term, where some patients actually can fall off the bandwagon in terms of taking their treatment long-term. So you need to be able to have established an appropriate relationship with your patient, and your patient will then tell you why is it that they're not adhering or persisting with their medications.
00:47
I have a patient that I've been giving some oral medications for the past couple of years, and she was really, really good at taking that medication over the first couple of years. But by the time it was the third year, I noticed because my pharmacist called me up and said that this patient hasn't been picking up her medication. So I called her in, I had the discussion, and I asked her, "Why is it, after all these years, you're not taking the medication?" And one of the key elements here was I think she forgot the importance of taking that medication, that it was reducing the risk of her disease coming back. And this patient had early-stage disease.
01:25
So it's sometimes very easy for patients to become complacent, they think they're doing well, which they are doing well because they're taking that medication, and it's sometimes important to reiterate. It may not be the only reason why they're not taking the medication, but I personally believe that the reasons why they don't take their medication early on versus later is something that you need to be able to define appropriately because I think that they're very different.
01:50
I also think that it's important that you incorporate various healthcare professionals in your team to be able to follow up with your patient. Nurses, nurse practitioners, sometimes the hospitalists, even the fellows that are in training with you, they can call up patients, they can talk to patients. Sometimes a patient may not feel that they can come and tell you that they're not taking the medication because they've been with you throughout the entire journey, and they don't want to make you feel that they've let you down in any way, shape, or form. So sometimes having just someone different ask them that question can give you the information that you're looking for.
02:25
So a simple strategy, always simplify the regimen characteristics to your patient. Let them know that it's easy to take the medication. It's not as difficult as it may seem. Make sure that you are imparting the correct knowledge to your patient at different time points. Understand your patient's beliefs. See if you can modify it to allow them to be able to take the medications appropriately. Make sure that you're having appropriate communication, not only with a patient but also their family members. Because like I said before, culture does make a difference. And there are some cultures where family members probably have a more important role to play in patient adherence and persistence more than what the physician will have in that role.
The way I look at persistence and adherence to medications, I think I would look at it in two aspects. You have persistent adherence to medication early on, and you have persistent adherence to medications that you're giving your patient long-term, where some patients actually can fall off the bandwagon in terms of taking their treatment long-term. So you need to be able to have established an appropriate relationship with your patient, and your patient will then tell you why is it that they're not adhering or persisting with their medications.
00:47
I have a patient that I've been giving some oral medications for the past couple of years, and she was really, really good at taking that medication over the first couple of years. But by the time it was the third year, I noticed because my pharmacist called me up and said that this patient hasn't been picking up her medication. So I called her in, I had the discussion, and I asked her, "Why is it, after all these years, you're not taking the medication?" And one of the key elements here was I think she forgot the importance of taking that medication, that it was reducing the risk of her disease coming back. And this patient had early-stage disease.
01:25
So it's sometimes very easy for patients to become complacent, they think they're doing well, which they are doing well because they're taking that medication, and it's sometimes important to reiterate. It may not be the only reason why they're not taking the medication, but I personally believe that the reasons why they don't take their medication early on versus later is something that you need to be able to define appropriately because I think that they're very different.
01:50
I also think that it's important that you incorporate various healthcare professionals in your team to be able to follow up with your patient. Nurses, nurse practitioners, sometimes the hospitalists, even the fellows that are in training with you, they can call up patients, they can talk to patients. Sometimes a patient may not feel that they can come and tell you that they're not taking the medication because they've been with you throughout the entire journey, and they don't want to make you feel that they've let you down in any way, shape, or form. So sometimes having just someone different ask them that question can give you the information that you're looking for.
02:25
So a simple strategy, always simplify the regimen characteristics to your patient. Let them know that it's easy to take the medication. It's not as difficult as it may seem. Make sure that you are imparting the correct knowledge to your patient at different time points. Understand your patient's beliefs. See if you can modify it to allow them to be able to take the medications appropriately. Make sure that you're having appropriate communication, not only with a patient but also their family members. Because like I said before, culture does make a difference. And there are some cultures where family members probably have a more important role to play in patient adherence and persistence more than what the physician will have in that role.