Health Literacy and Adherence

Medications prescribed for chronic conditions have the capacity to significantly reduce the effects of disease. However, medications will not work if they are not taken, and for this reason, adherence to treatment plans have been termed "the key mediator between medical practice and patient outcomes." (Kravitz and Melnikow, 2004). Unfortunately, up to 50% of patients are not adherent to long term medical therapy (World Health Organization, 2003). Efforts to identify and address causes for so staggering a number are therefore of great importance.

 

Engaging the Patient through Health Literacy

 

If someone doesn't know why they're taking a pill, they likely won't take it. More and more people are reluctant to follow "the doctor's orders", instead desiring to be engaged in decisions regarding their health together with their health care team. It is imperative patients understand their condition, their proposed treatment, and the consequences of their choices, positive and negative, regarding healthy living and treatment adherence. Effective, accessible education materials are needed for people to take ownership of their health and make the informed choices best for them.

 

In order to provide informed choice, education should be provided as treatments are being decided upon. Indeed, adherence during the first month of treatment is a powerful predictor of long term adherence (Dunbar, 1990). Easy-to-understand, facilitated education can help patients gain control during such a challenging time and assist them in make their own choices regarding treatments. An educated patient is an engaged patient, and a decision made in partnership is more likely to be followed than a prescription from the doctor the patient does not understand.

 

Taking a pill which makes an immediate, noticeable difference is motivating, but medication which doesn't promise a quick fix is more likely to be ignored or forgotten. Patients need to fully understand and be reminded of the benefits of taking medications for chronic conditions long term, and what happens if they do not.

 

Addressing other Issues of Non-Adherence

Some people equate taking medication with having an illness, and if people reject the notion that they are sick, they will not follow treatment (Pound et al, 2005). Not only is it important for people to what proposed treatment will do, therefore, they must also understand the condition for which it is being suggested. This is a critical educational need in increasing adherence rates.

Other people can be quite mistrustful of their doctors and medications and actively try to reduce their medication intake by changing dosage amounts or timing. In fact, in many cases, 'resistance' should be used instead of 'non-adherence' (Pound et al, 2005). This also leads much of the population to complementary and alternative medicines as they seek to improve their health in ways acceptable to them. In anticipation of these people, demonstrating the benefits of pharmaceuticals objectively, in the context of other options, will help allay suspicion the approaches Western medicine suggests.

 

Approaches to Improve Adherence

A variety of approaches have been used in attempts to improve adherence. Simple interventions can improve adherence to short-term medication plans, but success in treating chronic conditions has been smaller, even with complex, multifaceted programs that included education, counseling, and access (Haynes et al, 2005).

 

The most successful information interventions provide education over multiple sessions and address self-care issues. Monitoring and feedback approaches also appear useful (Kripalani et al, 2007). Clearly Health incorporates these approaches while providing innovative means of connecting patients with the information they need, promising to be awesome.

 

 

 

 

 

 

 

 

 

References

Dunbar J. Predictors of patient adherence: patient characteristics. In: Shumaker SA, Schron EB, Ockene JK, eds. The Handbook of Health Behavior Change. New York, NY: Springer Publishing Co Inc; 1990.

 

World Health Organisation (WHO). (2003). Adherence to longterm
therapies. Evidence for action, http://www.who.int/
chronic_conditions/adherencereport/en/

 

Lazarou, J., Pomeranz, B. H., & Corey, P. N. (1998). Incidence
of adverse drug reactions in hospitalized patients: a metaanalysis
of prospective studies. Journal of the American
Medical Association, 279(15), 1200–1205.

 

 

 

Notes

 

However, most efforts, even when adherence is improved, do not lead to better clinical outcomes.

 

question, then, is how to set up informed choice and have patients follow it?

answer is, in large part, due to health literacy.

 

Always ask about adhernece - a big deal! Same with diet and lifestyle...

 

AlignMap.com is an online resource dedicated to increasing the percentage of patients who follow their treatment plans.

"The clinician, as the healthcare expert, is responsible for not only informing the patient of the pros and cons of appropriate courses of treatment but also advocating those courses of treatment with the greatest chance of success for the specific patient."

 

 

Noncompliance is termed a 'catastrophe', resulting in much preventable suffering and death and wasting of time and money in the healthcare system.

 

The Health Belief Model suggests rational individuals will consciously weigh the pros and cons of a choice to follow a healthcare recommendation. It also predicts a patient will adhere to a treatment plan if she believes the health problem is significant, the treatment is likely to help, and the patient is able to implement the plan.