Treatment adherence: why do some patients drop out?

When it comes to implementing psychological or pharmacological treatments, not everything depends on the experience and the will of doctors or psychologists. In fact, there is one potential problem that can cause the entire cure or symptom remission plan to fail: failure to adhere to treatment.

The truth is that often the improvement in the health of patients is interrupted (or does not start) because they decide to leave the intervention program, or only partially comply with it, for example. forgetting to take pills very often or not to practice the exposure technique in case you want to control a phobia.

However …what do we know about treatment adherence and to what extent can not giving up on them be strengthened?

    Why it is important not to give up on treatment

    When faced with certain medical problems, it is important to follow the treatment in a disciplined manner if you do not want to risk serious damage to your health or even death. However, although the consequences should not be serious, the lack of adherence to treatment it always produces negative consequences. The main ones are:

    Increase in health spending

    The resources, effort and time invested in initiating psychological or medical treatment are wasted if the health improvement program is abandoned.

    subjective discomfort

    Although some diseases and disorders go away or go away without intervention, in many cases lack of adherence it directly generates an increase in discomfort or, directly, no improvement occurs.

    Emergence of an idea of ​​inefficiency

    some patients they interpret the very abandonment of the treatment as a failure of it, This means that the negative sensations they experience later due to a lack of palliative or curative measures are perceived as ineffective by the healthcare team.

    Is lack of treatment adherence common?

    From what is known from the extensive research conducted on this subject, non-adherence to treatment is one of the serious problems facing any health system.

    In fact, about half of people with chronic conditions and illnesses decide to stop treatment or forget about it. Outraged, nearly three quarters of people stop taking prevention programsAnd nearly a third of people with non-chronic health problems or psychological problems do the same with measures to improve their condition.

    The profile of those most likely to drop out is that of someone with a chronic condition who needs to make major lifestyle changes. For example, a person with bipolar disorder who has been advised, among other things, to write a journal and reflect in the morning and afternoon on the best way to manage personal relationships.

    The opposite occurs in people who, faced with an acute health problem or a one-off psychological crisis, must go to the clinic in order to be able to apply the treatment directly to them. This tendency not to stop collaborating with the health program it is more important if the improvement in symptoms occurs quickly.

    How to involve patients?

    Here are some measures that have been shown to be effective in preventing non-adherence to treatment:

    1. Constant communication

    The therapist-patient bond must be fluid and based on good rapport. This means that all doubts should be resolved and space should be left for the patient to ask questions and express insecurities.

      2. Offer personalized treatment

      To avoid the problems that may arise, it is necessary to know even superficially what is the lifestyle of each patient, and his beliefs or level of knowledge of your problem. For example, if there is prejudice against drug treatments at home.

      3. Start treatment alongside another desirable habit.

      To make change seen as a positive thing, it is possible pair it with a better lifestyle and healthier in the eyes of every patient. For example, the same day you take the first pill, start with a much healthier diet designed to improve your overall health.

      It also allows you to create a compensatory mechanism. For example, someone who believes that taking a capsule in the morning will not have a great effect may interpret it as part of the routine of starting with a glass of water first, or may understand that it is t is a healing proposition that is combined with one that is better tolerated, covering all fronts of health intervention. In this way, an overall improvement is used, without leaving a blind spot.

      4. Motivate through other mechanisms

      In some specific settings, programs may be used to strengthen treatment adherence. For example, the use of the economical chip, which can be used at home, in schools or in hospitals.

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