Adherence To Treatment: Why Do Some Patients Drop Out?
When implementing psychological or pharmacological treatments, not everything depends on the experience and willpower of doctors or psychologists. In fact, there is a potential problem capable of causing the entire plan to achieve cure or remission of symptoms to fail: lack of adherence to treatment.
The truth is that many times the improvement in patients’ health is interrupted (or does not begin) because they decide to abandon the intervention program, or only partially comply with it, for example, forgetting to take your pills very often or not practicing the exposure technique in case you want to control a phobia.
However…What do we know about adherence to treatments? And to what extent can the non-abandonment of these be promoted?
When faced with certain medical problems, it is important to follow the treatment in a disciplined manner if you do not want to be at risk of suffering severe damage to your health, or even death. However, even if the consequences do not have to be serious, lack of adherence to treatment always produces negative consequences. The main ones are the following:
Rise in health spending
The resources, efforts and time invested in starting psychological or medical treatment are wasted if the health improvement program is abandoned.
Although some diseases and disorders disappear or remit without the need for intervention, in many cases the lack of adherence directly generates an increase in discomfort or, directly, an improvement does not occur.
Appearance of idea of inefficiency
Some patients interpret the very abandonment of treatment as a failure of this which means that the negative sensations they experience later due to the lack of palliative or curative measures are perceived as ineffectiveness on the part of the healthcare team.
Is lack of adherence to treatment common?
From what is known from the numerous investigations carried out on this topic, lack of adherence to treatments is one of the serious problems that any health system must face.
In fact, around half of people with chronic disorders and diseases decide to interrupt treatment or forget about it. Besides, 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 abandon treatment is that of someone with a chronic problem who must make significant changes to their lifestyle. For example, someone with Bipolar Disorder who has been recommended, among other things, to keep a diary and to consider in the mornings and afternoons how they can better manage their personal relationships.
The opposite occurs in those people who, faced with an acute health problem or a specific psychological crisis, must attend the clinician to directly apply the treatment. This tendency to not stop collaborating with the health program It is greater if the improvement of symptoms occurs quickly.
These are some measures that have been shown to be effective in avoiding lack of adherence to treatment:
1. Constant communication
The therapist-patient bond must be fluid and based on good rapport. This means that any doubts must be resolved and that space must be left for the patient to ask their questions and express their insecurities.
2. Offer individualized treatment
To prevent problems that may arise, it is necessary to know, even in a superficial way, what the way of life of each patient is, and their beliefs or level of knowledge about your problem. For example, if there are prejudices against drug-based treatments in your home.
3. Start treatment with another desirable habit
To make the change perceived as something positive, it is possible associate it with a better lifestyle and healthier in the eyes of each patient. For example, on the same day you take the first pill, start with a much healthier diet designed to improve your general state of health.
This also allows creating a compensatory mechanism. For example, someone who believes that taking a capsule in the morning will not produce great effects may interpret it as part of the routine that involves starting by drinking a glass of water, or may understand that it is a healing proposal that is combined with another that 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 the token economy, which can be used at home, in educational centers or in hospitals.
