Medication adherence is a less-discussed and often overlooked topic, when we speak of general healthcare, but its impact on patient health cannot be overstated.
Effective treatment is not just about consulting a doctor, buying medicines or following the plan for a few days. What patients globally miss out on is sticking to the prescribed plan. While there are many factors that decide the success or failure of any treatment, medication adherence and patient compliance are the most important.
To gain a better understanding of these factors and their impact on treatment success, we talked to consultant physician and cardiologist Dr.Vivek Baliga of Baliga Diagnostics. Over the course of a career spanning 20 years, he has had a wealth of insights on treatment and medication adherence.
Q: What has been your experience with patients and how they follow your prescription?
Initial treatment is often a simple matter of prescribing medication and pills, when patients approach me with chronic issues like diabetes. Even if the patient is medication naive – someone who doesn’t understand the details of his condition or how the given medication helps – they’ll have a number of questions that can be easily answered. But as the condition progresses, as most chronic diseases eventually do, the requirement for medicine goes up and that’s where compliance issues begin.
Q: In your opinion, why do patients move away from the recommendations you give them?
There are many reasons why that might happen. Skipping medicines because they were stressed at work, or they had guests over or they lost the prescription and it’s too confusing now. While excuses are aplenty, medication non-adherence is the biggest factor that can slow down disease management. Studies from WHO show that even in developed countries, only 50% of chronic patients adhere to the treatment plan properly, and in developing countries, it’s even worse.
Cost is also a factor that can impact a patient’s ability to follow their prescription. Healthcare is not cheap in India and an effective solution has to be made for this problem. In the meantime, effective communication regarding their treatment is all that can be done.
Q: What do you mean by “effective communication” in terms of prescription and treatment?
In my practice, around 30-35% of my patients exhibit poor medication adherence. My experience varies from some doctors, probably because of the extra time spent explaining tablets. But for doctors who consult in hospitals, busy schedules may not give them the chance to give each patient the time they deserve.
When there is a lack of information, even with antibiotics – there are people who will just take a medicine given for five days for a three day period and then stop because they are feeling better. But if you can tell people how it will benefit them in the long run, the attempts will have a better response.
Q: Do you have any personal stories where effective communication helped in improving medication adherence?
Recently, I’ve been prescribing a diabetes drug that can reduce the chance of heart attacks by 20-30%. When I tell my patients this, they look beyond their concerns and stick to the prescription.
Even if it’s an expensive medicine, they’ll somehow try to stick to the prescription plan. This is what I mean by effective communication – if the message has gone across well, patients will be very compliant.
Q: Tell us your thoughts about digital healthcare. How can apps like Phable improve medication adherence?
While I firmly believe that all doctors need to take time out to educate their patients, if there’s a way to tailor and personalize medical data and health advice to individual patients based on their unique history – life will be easier for both doctors and patients.
In my initial years of practice, I’ve seen prescriptions being handed out and doctors simply taking the patient’s word that the treatment plan is being followed. Now we’re all more tech-savvy, we’ve got smartphones that track physical activity. There are young adults actively monitoring their parents’ health with technology.
If apps like Phable bring together medical records, patient history, daily reminders and activity tracking, they can improve the effect of everyday treatment in all patients and help doctors deliver better care. Digitization and crucial health data can help doctors deliver better results and establish preventive care.
Phable is an innovative lifestyle disease management app simplifying life for patients & doctors through health monitoring and doctor intervention.