Best Ways to Deal With Noncompliant Patients

Mark Crane, BA

Disclosures

June 05, 2009

In This Article

Best Ways to Boost Patient Compliance

Physicians face 2 chief noncompliance challenges: patients who can't comply due to financial reasons, and those who don't want to make the effort to lose weight, test their blood sugar, or say no to harmful lifestyle choices.

For doctors, it's vitally important to take time to tell patients why the treatment is necessary.

"As many as 1 in 5 patients don't fill the original prescription because the doctor didn't convince them that they really needed it," says Kellerman. "It takes time to sit down with the patient and make sure they have all the information they need, but currently, the reimbursement system and shortage of primary care doctors doesn't make that easy."

"There are multiple reasons for noncompliance," adds Donald J. Palmisano, MD, JD, a vascular surgeon/attorney in Metairie, Louisiana, and former president of the American Medical Association (AMA). "Patients may not understand what you told them. I typically ask the patient to repeat back to me what it is he's supposed to do. It's important to explain that if the patient doesn't take the medicine, he's at increased risk for stroke or some other illness.

"If I suspect the patient is unclear, we give written instructions and may follow up with phone calls. It's important to know if the patient is able to read. I've been amazed over my career at how many patients cannot," says Dr. Palmisano.

Patients need to know what the drug is and how it works in terms that are understandable to them. How and when should they take the drug? For how long? What side effects can be expected? What are the consequences of stopping the medication? If doctors can answer these questions, it's far more likely that your patients will follow your advice.

Depending on your practice workflow, it may be useful for a medical assistant or nurse to discuss the prescription with the patient. He or she can stress the importance of the prescription and make sure the patient understands what is expected.

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