Why aren't more physicians providing patient education?
The reason more physicians aren’t providing patient education is not because they don’t want to, it’s because they find it a challenge to devote adequate time to it while managing their practice. This is understandable. It is also why healthcare platforms, like the Virtual Practice, have a Health Network.
How can a teaching physician improve health care outcomes?
—Norman Cousins, Anatomy of an Illness To improve health care outcomes, physicians must spend more time with patients. The teaching physician's interaction with the patient must be enthusiastic, motivated, and responsive to the individual patient's needs.
What is the role of patient education in healthcare?
Patient education is a basic right of the patients and healthcare members have responsible to provide such information. However, the authenticity of the available information is yet to be verified. Therefore, healthcare professional could play a vital role here to educate their patients about the appropriate information.
What is the relationship between the teaching physician and the patient?
The teaching physician's interaction with the patient must be enthusiastic, motivated, and responsive to the individual patient's needs. For individual members of our society to realize the benefits of physician health education, there is a need for a robust, hearty engagement between patients and physicians.
Does patient education improve medication adherence?
Patient education and provision of tools to help patients overcome adherence barriers are effective ways to improve medication adherence. Medication adherence is a common barrier to achieving desired therapeutic outcomes. Patient education is proving to be an important component to increase medication adherence.
What increases patient adherence?
Successful strategies to improve medication adherence include 1) ensuring access to providers across the continuum of care and implementing team-based care; 2) educating and empowering patients to understand the treatment regimen and its benefits; 3) reducing barriers to obtaining medication, including cost reduction ...
Why is it important to adhere to medication regimen?
Taking your medicine as prescribed or medication adherence is important for controlling chronic conditions, treating temporary conditions, and overall long-term health and well-being. A personal connection with your health-care provider or pharmacist is an important part of medication adherence.
What is the best predictor of adherence to a care plan?
In meta-analytic work, findings suggest that one of the strongest predictors of patient nonadherence to medical treatment is patient depression (DiMatteo et al 2000).
What is adherence to treatment?
Adherence to treatment, the extent to which patients are able to follow the agreed recommendations for prescribed treatments with healthcare provider, is a key component of chronic disease management.
What does increase adherence mean?
Adherence is defined as 'the extent to which the patient's behaviour matches agreed recommendations from the prescriber' 1. Adherence describes patient behaviour in the actual taking of medicines.
What are the benefits of adherence?
Taking your medicines for as long as prescribed, at the right time and dose, and according to instructions, can help you feel and stay well. Practicing medication adherence assures the maximum beneficial impact of the medicines you take. It also minimizes risk.
Is adherence necessary in healthcare?
Adherence to therapies is a primary determinant of treatment success. Failure to adherence is a serious problem which not only affects the patient but also the health care system. Medication non adherence in patients leads to substantial worsening of disease, death and increased health care costs.
How can you make patients adhere to medication?
Nine Tips for Improving Medication AdherenceEducate patients about what to expect. ... Nurture relationships with patients. ... Team up with prescribers. ... Engage the staff. ... Learn about and use available technologies. ... Help patients customize their support tools. ... Schedule appointments. ... Synchronize medications.More items...•
What is adhere in healthcare?
In medicine, patient compliance (also adherence, capacitance) describes the degree to which a patient correctly follows medical advice.
What is meant by patient adherence What are some factors related to seeking medical treatment who will and will not use health services?
Adherence to medicines is defined as the extent to which the patient's action matches the agreed recommendations. Non-adherence may limit the benefits of medicines, resulting in lack of improvement, or deterioration, in health.
Why do patients not adhere to medical advice?
Depending on the patient, provider, and situation, contributing factors may include the patient's social and economic status or education level, the complexity of the treatment and instructions, health system variables, poor provider communication, patient depression or stress, and physical or financial obstacles to ...
What is the primary determinant of treatment success?
Adherence to therapies is a primary determinant of treatment success. Failure to adherence is a serious problem which not only affects the patient but also the health care system. Medication non adherence in patients leads to substantial worsening of disease, death and increased health care costs. A variety of factors are likely to affect adherence.
Why do patients become non-adherent to medication?
One of the major reasons that patients become non adherent is because they forget to take their medications . Results of a study conducted showed that 49.6% of patients mentioned forgetfulness as one of the major non-intentional reasons for non adherence.49Forgetfulness can be taken care by reminders i.e. through directly mailed letters, telephone, e-mails, text messages to cellular phones and alarms; even though it may not be practically possible in all work settings. Involving the patient’s care givers would be an additional way of combating non adherence due to forgetfulness.
What is non adherence?
A second type of non adherence is called non persistence in which patients decide to stop taking a medication after starting it, without being advised by a health professional to do so . Non persistence is rarely intentional and happens when patients and providers miscommunication about therapeutic plans.
Why is patient involvement important in decision making?
Patient involvement in decision making is essential in improving medication adherence. It is vital for health care providers to identify the underlying causes of patient non adherence to determine appropriate interventional strategy.
What is medication adherence?
Medication adherence is defined by the World Health Organization as "the degree to which the person’s behavior corresponds with the agreed recommendations from a health care provider.". 1Though the terms adherence and compliance are synonymously used adherence differs from compliance.
How to assess adherence in children?
Assessing children’s adherence can be done by asking the help of a care giver (school nurse or teacher). Among the various methods questioning the patient, patient diaries and assessment of clinical response are all methods that are relatively easy to use, but questioning the patient can be susceptible to misrepresentation and tends to result in the health care provider overestimating the patient’s adherence.
How much does adherence to drug therapy vary?
It has also been observed that patient non adherence varies between and within individuals, as well as across time, recommended behaviors and diseases.32Adherence to drug therapy varies with patient age group also. In children, adherence to drug therapy is affected due to their dependence on an adult care giver. The literature concerning adherence reports in elderly patients reports that compliance rates range roughly from 38%- 57% with an average rate of less than 45%.33,34
What is patient education?
Patient education is defined as “A systematic experience in which a combination or a variety of methods are used. These might include the provision of information and advice and behaviour modification techniques, which influence the way the patient experiences his illness and/or his knowledge and health behaviour, aimed at improving or maintaining or learning to cope with a condition, usually a chronic one”[ 44]. The concept of patient education is to train patient in the skill and self-management of their chronic disease by adapting to the treatment or lifestyle changes [ 45]. Despite improving in patients’ skill and self-care by providing information about the treatment, patient education could enhance their empowerment and medication adherence [ 46]. In addition, patient education could reduce the medical expenses in terms of long term care for both patients and society [ 45]. Patient education plays an important role in therapeutic plan by improving patients’ self-management skills [ 47] and to enhance patient-centred perspective [ 48].
What is essential medicine?
Essential medicines are defined as those medicines that satisfy the priority health care needs of the population in a country [ 1]. Essential medicines have become indispensable to maintain and to improve our lives and health [ 2]. Additionally, essential medicines play a significant role in therapeutic assets of medical treatment options. Yet, medicines still are unaffordable, unavailable, unsafe and inappropriate used among many people around the globe [ 3][ 4]. World Health organisation (WHO) has defined Quality Use of Medicine (QUM) as “Patients receive medications appropriate to their clinical needs, in doses that meet their own individual requirement, for an adequate period of time, and at the lowest cost to them and their community”[ 5]. Australian National Medicines Policies has defined QUM as “selecting management and suitable medicine wisely, and using medicines safely and effectively”[ 6].
How can a physician provide effective patient education?
According to Katz,[20]physicians can provide effective patient education by (1) limiting instructions to 3 or 4 major points during each discussion; (2) using simple, everyday language, especially when explaining diagnosis and giving instructions; (3) supplementing oral teaching with written materials; (4) involving the patient's family members and friends; and (5) reinforcing the concepts discussed.[20] This is especially true for millions of citizens with low literacy skills.
Why is it important to address patients' beliefs, intentions, and self-efficacy?
This is because knowledge alone is not sufficient to enhance adherence in recommendations involving complex behavior change. [21,22,23]
What is the problem with nonadherence to medication?
The problem of poor adherence to medical treatment is a well-recognized problem in the literature. [1–4]Studies have shown that in the United States alone, nonadherence to medications causes 125,000 deaths annually and accounts for 10% to 25% of hospital and nursing home admissions.[5] This makes nonadherence to medications one of the largest and most expensive disease categories. Moreover, patient nonadherence is not limited to medications alone. It can also take many other forms; these include the failure to keep appointments, to follow recommended dietary or other lifestyle changes, and to follow other aspects of treatment or recommended preventive health practices. Hence, the actual implications of nonadherence go far beyond the financial aspect of medication nonadherence, as estimated above.
How can a clinician optimize behavior change?
Clinicians can optimize behavior change by ensuring that the patients (1) perceive themselves to be at risk due to lack of adoption of healthy behavior (perceived susceptibility), (2) perceive their medical conditions to be serious (perceived severity), (3) believe in the positive effects of the suggested treatment (perceived benefits), (4) have channels to address their fears and concerns (perceived barriers), and (5) perceive themselves as having the requisite skills to perform the healthy behavior (self-efficacy).
What is patient communication?
Patient communication encompasses interventions ranging from physician-patient communication, sending mail or telephonic reminders, to involving patients' families in the dialogue. Of these, the most problematic is physician-patient communication. At least 50% of patients leave their doctors' offices not knowing what they have been told. Studies have shown that (1) 50% of psychosocial and psychiatric problems are missed by physicians due to lack of proper communication[25]; (2) physicians interrupt patients on an average of 18 seconds into the patients' descriptions of the presenting problems[26]; (3) 54% of patients' problems and 45% of patient concerns are neither elicited by the physician nor disclosed by the patient[27]; and (4) 71% of patients stated poor relationships as a reason for their malpractice claims. [28]
Is understanding of a patient's condition related to adherence?
Research has consistently demonstrated that patients' understanding of their conditions and treatments is positively related to adherence, [15]and that adherence, satisfaction, recall, and understanding are all related to the amount and type of information given. [16]
Do patients always understand prescription instructions?
Many studies have shown that patients do not always understand prescription instructions and often forget considerable portions of what healthcare practitioners tell them. [17,18]Studies have shown that patients who understand the purpose of the prescription are twice more likely to fill it than those who do not understand the purpose. [19]
Why are these efforts shown to improve medication adherence?
These efforts are shown to improve medication adherence because they help patients understand the drugs they are taking, when they should take them, and why.
Why are patients not confident in their own drug regimens?
The survey of 200 patients without chronic conditions revealed that more than half of patients are not confident in managing their own drug regimens because they did not receive adequate patient education on the matter.
How does ONC help with prescribing errors?
A 2016 ONC report outlined how providers engaging their patients during the drug prescription process can help identify prescribing errors. Specifically, providing patients with after-visit summaries, reviewing the summaries with patients, and utilizing patient teach back to outline a medication regimen are helpful strategies. These efforts will also ensure patients are taking their medications at the right dosage and follow other important protocol.
Why do doctors explain how to take medications?
Providers who explain to patients how to take their medications – taking pills on a full or empty stomach, or at certain time intervals, for example – can increase medication adherence and drug safety in their patients.
Why do people not fill their prescriptions?
A 2017 report from Consumer Reports Best Buy Drugs found that 14 percent of patients do not fill their prescriptions because of medication costs .
How many people are paying more for their medications than they did a year ago?
One-quarter of patients are paying more for their medications than they did one year ago. Seventy-four percent of those patients said that they received no prior warning of a drug price increase, and 24 percent say they likely will not be able to continue paying for their medications in the future.
What can a health coach do for a patient?
If the patient is experiencing financial woes, health coaches can work with the patient to find a generic alternative or rework the regiment to be more financially efficient. What’s more, patient education can improve medication safety.
Why aren't doctors providing patient education?
The reason more physicians aren’t providing patient education is not because they don’t want to, it’s because they find it a challenge to devote adequate time to it while managing their practice. This is understandable. It is also why healthcare platforms, like the Virtual Practice, have a Health Network. The Health Network is a health communication channel that is exclusively dedicated to encourage discussions among doctors and patients. Unlike social media platforms, this network aims to bring together like-minded people to support and facilitate better health outcomes.
Why is patient education important?
Hence it is equally important that your patient education platform has a provision for patients to ask questions about the articles that you are posting. This is perhaps one of the biggest benefits of having provider-generated content as opposed to obscure content on other websites. Patients are likely to value this type of interaction as there is more accountability and ownership of content. Encouraging questions also makes you a better physician.
What are the benefits of the Health Network?
One of the advantages of the Health Network is that it collates online published health information for health providers to share with their patients. Share articles and helpful tips from the network that you think may be useful to your patients without having to spend much time writing them yourself. The Health Network also serves as a means of interacting with other physicians and getting the latest medical news from across the globe, serving also a means of physician education.
What does empowerment mean for patients?
Unlike what many health providers may be led to believe, patient empowerment does not mean that their patients will have no need for them. On the contrary, empowering and educating patients only serves to have them approach you rather than rely on multiple (online or offline) sources for information on their health.
Why do doctors bring out printouts from Wikipedia?
Physicians often complain that their patients bring sheets of printouts from Wikipedia and other websites to explain their symptoms or support their self-diagnosis of health conditions. A simple headache can be made to seem like a symptom of brain tumour, causing most uninformed readers anxiety and sleepless nights.
Why is it important for doctors to balance patient education?
It is a tough call for doctors to make as they are required to balance providing information for patient education in order to ensure transparency in care versus having to be sensitive to how patients will receive said health information.
Why is it important to educate patients?
This means that they are aware of their health condition and why they need to carry out certain procedures or follow specific treatments outlined by their providers. This reduces misconceptions about doctors recommending unnecessary procedures to patients as well.
How can physicians improve health care outcomes?
To improve health care outcomes, physicians must spend more time with patients. The teaching physician's interaction with the patient must be enthusiastic, motivated, and responsive to the individual patient's needs. For individual members of our society to realize the benefits of physician health education, there is a need for a robust, hearty engagement between patients and physicians.
Why is patient health literacy important?
Critical to any educational process is time. The development of patient health literacy is crucial to our proven health prevention measures of exercise and diet. Patients must have a deep understanding of the impact healthy interventions can have on their present and long-term health. Physicians will need to spend time and energy educating patients to see behavioral change that results in improved health outcomes and reduced morbidity and mortality due to preventable chronic diseases such as diabetes, obesity, and coronary and cerebrovascular disease. As physicians, we will know when we have reached the threshold of being an excellent teacher by observing responsible patients.
What is informed consent?
Medical informed consent should be an exchange of ideas that buttresses the patient-physician relationship. The consent process should be the foundation of the fiduciary relationship between a patient and a physician. Physicians must recognize that informed medical choice is an educational process and has the potential to affect the patient-physician alliance to their mutual benefit. Physicians must give patients equality in the covenant by educating them to make informed choices. Patients must use the educational process to make rational health choices.
What is the role of a physician in a patient's care?
Physicians have a duty to inform patients how to achieve health and wellness, and patients have a responsibility to act on the information provided in their best health interest. Medical informed consent is essential to the physician's ability to diagnose and treat patients, as well as the patient's right to accept or reject clinical evaluation, treatment, or both.
How does health literacy affect patients?
Physicians must promote patient education and engagement through improvement in patients' health literacy. Health literacy is defined as the capacity to seek, understand, and act on health information (4). The presumption has been that low health literacy means that physician communication is poorly understood, leading to incomplete self-health management and responsibility and incomplete health care utilization (5). It is the responsibility of physicians to proactively enable patients to have more accessible interactions and situations that promote health and well-being. Health literacy is the primary responsibility of physicians, given that it is physicians who determine the parameters of the health interaction, including physical setting, available time, communication style, content, modes of information provided, and concepts of sound health care decision crafting and acquiescence. There are communication methodologies and behaviors that physicians can implement to ameliorate the potential risks associated with limited patient health literacy, including avoiding medical jargon, engaging in patient questions, explaining unfamiliar forms, and using “teach back” as a method to ensure understanding (6).
What is self-efficacy intervention?
Self-efficacy is defined as one's belief in one's ability to succeed in specific situations, or accomplish certain tasks. One's sense of self-efficacy plays a major role in how one approaches goals, tasks, and challenges regarding one's health. Clinical benefits have been seen in trials of lifestyle intervention within a wide range of conditions such as diabetes, coronary heart disease, heart failure, and rheumatoid arthritis (1).
Does exercise reduce the risk of heart disease?
There is a belief in the medical community that physical activity and diet can reduce the risk of developing coronary artery disease, hypertension, diabetes, and the metabolic syndrome. A comprehensive systematic review reinforced this notion by revealing that there is irrefutable, convincing evidence for the benefit of exercise in improving clinical outcomes in metabolic disorders, coronary heart disease, and heart failure (3).
Why is patient education important?
It is important to remember that patients are more likely to be adherent to medication regimens for treatment of depression if they are convinced of the necessity of treatment and have sufficient concern regarding their health; thus, patient education will enhance the likelihood of treatment adherence.
Why should policy be enhanced at the population level?
Policy at the population level should be enhanced to increase demand for quality care of patients with depression and to develop capacities at the local, state, and national levels. The adage "think globally but act locally" comes to mind.
How does stigma affect treatment?
A number of factors contribute to nonadherence ( Table 2 ); for instance, stigma that is real, or perceived as real by the patient, interferes with adherence to treatment plans . In a study by Sirey and associates, 21 134 depressed patients were assessed for perception of stigma related to depression as well as their view of the severity of the depressive disorder. Findings showed that lower perceived stigma and higher self-rated severity of illness were associated with better adherence to the recommended treatment regimen. In this study, 52% of patients were taking an SSRI, 23% were taking a TCA, and 25% were taking another antidepressant; adverse effects were not associated with adherence.
Why is adherence to TCAs so poor?
16 There are a host of reasons patients may have treatment-adherence difficulties with TCAs, including adverse effects and complicated dosing (eg, starting with a low dose and titrating to a therapeutic range).
What is adherence to medical management of major depression?
Adherence to medical management of major depression is a complex phenomenon that goes far beyond the adverse effects issue of the old versus the new antidepressants. The adherence measures of HEDIS assume that the practitioner is prescribing care consistent with the guidelines; it is recognized that there may be practitioner variables that dilute adherence to treatment (such as not scheduling follow-up appointments or not prescribing for sufficient periods). 20
How many times did a psychiatric nurse increase adherence?
Those who had contact with a psychiatric nurse increased their adherence by 1.4 times during the 2 phases. Adherence to medical management of major depression is a complex phenomenon that goes far beyond the adverse effects issue of the old versus the new antidepressants.
What are the different degrees of adherence?
There are different degrees of adherence, from complete to rare or nonexistent adher ence. This article seeks to examine what underlies difficulties and challenges with treatment adherence of major depressive disorder and identifies approaches that the clinician can use to improve patient adherence to treatment.
What is the primary outcome of the Brief Medication Questionnaire?
The primary outcome was self-reported adherence on the Brief Medication Questionnaire, with adequate early adherence defined as taking 80% or more of the prescribed doses at 6 and 12 weeks. The secondary outcome was depression severity.
Why are older adults less able to abide to medication?
Although older adults face structural barriers (eg, costs of medications, distance from home to physician’s office), often negative attitudes are the most important factors affecting adherence. Perceived stigma predicts poorer medication adherence and treatment discontinuation among elderly people with depressionOlder adults worry about having a diagnosis of depression, especially older adults of African descent. Low perceived symptom severity is associated with poorer adherence,and even when distress is acknowledged, many older adults feel they should not need mental health help. In a community-based study of older adults, when perceived costs outweighed perceived benefits, nonadherent behaviors were more likely.
What are the risk factors for nonadherence?
Key risk factors for nonadherence include age, comorbid conditions, beliefs about treatment, and concerns over adverse events. In the elderly population, additional risk factors may include patient variables such as the lack of a medication routine, retaining discontinued medications, combining prescriptions, and multiple storage locations. Medication adherence problems also increase with the total number of drugs prescribed. The average older American adult takes 3 prescription and 4 over-the-counter medications daily, and those with depression typically take more medications. Even in successful clinical intervention studies for older adults with depression, nonadherence is a challenge.
What is treatment initiation and participation program?
The Treatment Initiation and Participation Program is an effective intervention to improve early adherence to pharmacotherapy. Improved adherence can promote improvement in depression.
Who had full access to all of the data in the study?
Author Contributions:Drs Sirey and Kales had full access to all of the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis.
How old are participants in the TIP intervention?
Participants had a mean (SD) age of 67.3 (8.4) years. Participants in the TIP group were 5 times more likely to be adherent at 6 weeks (odds ratio, 5.54; 95% CI, 2.57 to 11.96; χ21 = 19.05; P < .001) and 3 times more likely to be adherent at both 6 and 12 weeks (odds ratio, 3.27; 95% CI, 1.73 to 6.17; χ21 = 13.34; P < .001). Participants in the TIP group showed a significant earlier reduction (24.9%) in depressive symptoms (95% CI, 13.9 to 35.9; t337 = 4.46; adjusted P < .001). In both groups, participants who were 80% adherent at weeks 6 and 12 had a 15% greater improvement in depressive symptoms from baseline over the course of treatment (95% CI, −0.2 to −30; t369 = 1.93; P = .051).
When was the Tip study?
The Treatment Initiation and Participation Program (TIP) was offered in a 2-site randomized clinical effectiveness study between January 2011 and December 2014 at primary care practices in New York, New York, and Ann Arbor, Michigan. Analyses began in February 2016. All participants were middle-aged and older adults (aged ≥55 years) who received newly initiated depression treatment by their primary care physician and recruited within 10 days of their prescription. Analyses were intention-to-treat.