Breaking Barriers to Medication Adherence in HIV: An Interview With Robert Gross, MD

Robert Gross, MD; Shira Berman


August 05, 2013

In This Article

Learning From Others' Experience

Medscape: The title of the panel was "Tips for Addressing Adherence With Patients."[1] What were the key takeaways tips that panelists shared from their own experiences?

Dr. Gross: What came across strongly from all of the panelists is that being nonjudgmental is very important -- and very difficult for providers to do. It's difficult to have a patient who is engaging in a behavior that is risking her health and yet not have an emotional reaction that comes across as negative or as demeaning to the patient.

We talked about how providers can instead try to be positive about the good things the patient is doing. For example, if he took 2 doses in the month, try to build off of that rather than focusing on the other 28 missed doses.

Patients are aware of their own nonadherence. It's not simply that they are forgetting doses but more that they're avoiding doses or they're not recognizing that they're forgetting doses. They're not necessarily going to want to talk to someone about that if they feel they're being judged for their behaviors.

One point that was emphasized by Dr. Ira Wilson, who facilitated the session, was the importance of using open-ended questions. This lets the patient express himself and gives him an opportunity to talk about the challenges he is facing.

For example, asking questions such as "How are you doing with your medications?" and "How are the medications working for you?" opens the dialogue to a much more productive discussion and allows for a better give-and-take conversation about the kind of help the patient might need. Asking open-ended questions is not something that is easy for doctors to do, but it is something that is very important for us to try to implement.