StrokeSense : Physician's Resource

The Adherence Factor

Studies have shown that just talking about lifestyle changes, such as eating healthy, losing weight, and controlling stress, isn't enough. Nonadherence has been found to be a major problem in lowering stroke risk, and physicians are challenged to work with each patient to ensure that he or she adheres to treatment.

If a patient isn't following your recommendations, there are often underlying reasons. The patient may not understand the importance of a medication or a lifestyle recommendation. The patient also may fear a medication and its side effects or face financial constraints or cultural barriers. Open communication can help physicians discover these barriers.

To improve patient adherence with stroke therapies, follow these tips from the National Council on Patient Information and Education:

• Involve the patient in treatment decisions and ask her or him to sign a consignment pledge.
• Monitor adherence at every office visit and follow up when needed.
• Establish an alternate contact person at your office.
• Coordinate medical regimens with other healthcare professionals and pharmacists.
• Make sure that all of your staff members are trained to effectively communicate with patients.
• Try not to ask patients "Yes" or "No" questions. Instead, ask open-ended questions that will encourage dialogue.
• Offer adherence monitoring and documentation for at-risk patients.
• Ask patients specifically if they use vitamins or other dietary supplements.
• Use educational pamphlets and other literature to reinforce recommendations.
• Assess your patients knowledge of medications and lifestyle changes, and then focus on education needs.
• Ask adherence questions at all patient visits.

For more information, visit www.talkaboutrx.org.

Reference

• Medication Compliance, American Heart Association, 2002.

Source of Material: RockHill Communications, 14 Rock Hill Road Bala, Cynwyd, PA 19004, (610) 667-2040,
Writer: Christine Norris
Editors: Erin Murphy, Andrea King, Joanne Poeggel, Ron Wozny
Clinical Reviewer: Patt Panzer, M.D.
Date Written: 4/30/01
Last Revised: 4/3/03