Nonadherence: Understanding and Addressing the Challenges of Treatment Noncompliance
Nonadherence to medical treatments is a significant problem in many countries across the world, with major implications for public health and patient outcomes. Medical nonadherence, also known as treatment noncompliance or noncompliance, occurs when an individual does not follow a prescribed plan of care, such as taking medication or following dietary guidelines. It is estimated that 50-60% of all medical treatments are nonadherent and that nonadherence to medications alone accounts for over 125,000 deaths annually in the United States (Centers for Disease Control and Prevention, 2020). The costs associated with medical nonadherence are estimated to be as high as $290 billion annually in the United States (Tseng et al., 2018).
The causes of nonadherence are varied and complex, and can include anything from a lack of knowledge or understanding of the treatment plan to intentional avoidance of care due to cost or other factors. Poor communication between healthcare providers and patients, cultural or language barriers, and poor access to care can also lead to nonadherence. It is important for healthcare providers to understand the individual factors that can lead to nonadherence in order to develop strategies to address it.
One of the most effective strategies for addressing nonadherence is patient education. This includes providing clear and accurate information about the treatment plan and helping the patient to understand the potential benefits and risks of the treatment. It also involves helping the patient to identify and understand any potential barriers to adherence, and to develop strategies to overcome them. For example, a patient may need assistance in finding transportation to their doctor’s appointment or help understanding how to take their medication correctly. Another important strategy is to ensure that the patient has access to needed resources, such as medication, medical supplies, and support services.
In addition to patient education and support, healthcare providers can also use motivational interviewing techniques to help patients understand their treatment plan and to identify any potential barriers to adherence. Motivational interviewing is a patient-centered counseling approach that encourages patients to explore and resolve their ambivalence about the treatment plan and to develop strategies to overcome any identified barriers. It is an effective strategy for increasing adherence to medical treatments, and has been shown to be particularly helpful for patients with chronic conditions (Kozlowski et al., 2015).
Finally, healthcare providers can use technology-based interventions to help improve adherence. Technologies such as smartphone apps, electronic medical records, and remote monitoring systems can be used to remind patients to take medications, monitor their progress, and provide support and feedback. These interventions can be especially helpful for patients who have difficulty accessing traditional healthcare services (Chen et al., 2017).
In summary, medical nonadherence is a major problem with significant implications for public health and patient outcomes. It is important for healthcare providers to understand the individual factors that can lead to nonadherence, and to develop strategies to address it. Patient education, motivational interviewing, and technology-based interventions can all be effective strategies for helping patients to adhere to their treatment plans.
References
Chen, C., Chien, Y., Wu, J. J., & Wu, Y. C. (2017). A systematic review of technology-based interventions for medication adherence. PLoS One, 12(3), e0173053.
Centers for Disease Control and Prevention. (2020). Medication adherence. Retrieved from https://www.cdc.gov/medication-adherence/index.html
Kozlowski, K.M., Gaglio, B., Pizzi, L.T., & Burke, L.E. (2015). Motivational interviewing to improve medication adherence: A systematic review and meta-analysis. Patient Preference and Adherence, 9, 1655–1665.
Tseng, C.L., Lin, W.H., Chung, C.Y., Ou, C.T., & Hsiao, C.J. (2018). Non-adherence to medications: A Taiwanese perspective. International Journal of Clinical Pharmacy, 40(1), 173-180.