When it comes to 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 making the whole plan to reach cure or remission of symptoms fail: lack of adherence to treatment.
The truth is that many times the improvement of the patients’ health is interrupted (or does not start at all) because they decide to abandon the intervention program, or only partially comply with it, for example, forgetting to take their pills very often or not practicing the exposure technique in case they want to control a phobia.
Now then… what do we know about the adherence to treatments and to what extent can we encourage the non-abandonment of these treatments?
Why it is important not to give up treatment
For certain medical problems, it is important to follow the treatment in a disciplined manner if you do not want to be at risk of severe health damage or even death. However, even if the consequences are not necessarily serious, failure to adhere to treatment always leads to negative consequences . The main ones are the following:
Increase in health expenditure
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, on many occasions the lack of adherence directly generates an increase in discomfort or, directly, no improvement occurs.
Appearance of idea of ineffectiveness
Some patients interpret the abandonment of the treatment itself as a failure of it , which means that the negative sensations they later experience due to the lack of palliative or curative measures are perceived as inefficacy by the healthcare team.
Is lack of adherence to treatment common?
As far as is known from the numerous investigations carried out on this subject, the lack of adherence to treatments is one of the serious problems that any health system must face.
In fact, about half of people with chronic conditions and diseases decide to stop treatment or forget about it. In addition, 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 people most likely to drop out of treatment is someone with a chronic problem who must make significant lifestyle changes. For example, someone with Bipolar Disorder who has been advised, 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, when faced with an acute health problem or a specific psychological crisis, must attend the clinic to receive treatment directly. This tendency not to stop collaborating with the health programme is greater if the improvement in symptoms occurs quickly.
How do you get patients to commit?
These are some measures that have been shown to be effective in preventing non-adherence to treatment:
1. Constant communication
The therapist-patient relationship should be fluid and based on a good rapport. This means that any doubts must be resolved and that space must be left for the patient to ask questions and express his or her insecurities.
2. Offer individualized treatment
In order to prevent problems that may arise, it is necessary to know even superficially what the lifestyle of each patient is, and their beliefs or level of knowledge about their problem . For example, if there are prejudices against drug-based treatments in your home.
3. Start treatment with another desirable habit
To make change perceived as something positive, it is possible to associate it with a better and healthier lifestyle in the eyes of each patient. For example, on the same day that the first pill is taken, start with a much healthier diet designed to improve the general state of health.
This also allows the creation of a compensatory mechanism . For example, someone who believes that taking a capsule in the morning will not produce great effects can interpret it as part of the routine that involves starting by drinking a glass of water, or they can understand that it is a healing proposal that is combined with another that is better tolerated, covering all the fronts of health intervention. In this way, an overall improvement is used, without leaving blind spots.
4. Motivating through other mechanisms
In certain special contexts it is possible to use programs to strengthen treatment adherence. For example, the use of token economy, which can be used at home, in schools or in hospitals.