Solving Patient Care Challenges Using a Psychological Approach
According to the World Health Organization (WHO), approximately 125,000 people with treatable ailments die each year in the United States because they do not take their medication properly.(1) The WHO also reports that up to 25% of hospital admissions result from noncompliance. Not taking medication as prescribed can account for up to 50% of treatment failures.
The World Health Organization identifies five dimensions with factors that may lead to these failures:(2)
- Type of diagnosis which causes “denial” or apathy about their condition or treatment.
- Type of therapy causing unpleasant side effects or any perceived negative side effects.
- Socioeconomic challenges and cost concerns this includes access to medical visits, availability of medications, costs of medications not covered, inability to take time away from the family or work.
- Individual traits, including memory and other cognitive challenges – issues such as anxiety or depression and physical challenges make adherence difficult without additional support.
- Healthcare providers and insurance systems – client engagement and activation strategies are critical to assisting patients comply with care.
Dan Ariely is a Professor of Behavioural Economics at Duke University and Ada Lê is the Vice President, Strategy at BEworks.
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What strategies work
There are a number of strategies that work to assist patients with self-care:
- Understanding the patient needs and their environments using the Patient Activation Measure (PAM) is a good start. However, don’t just tick a box, seek to ask questions to ensure that they are not telling you what they think you want to hear.
- Educate patients about their health and self management activities.
- Involve them in the decision-making about their aftercare.
- Discuss patient values and health-related goals.
- Assist them with home support (locally) using local and telehealth support.
- Understand their routines and help them create sustainable habits so they are less likely to “forget”.
- Help them celebrate small wins in improvement so that they feel like they have “improved” their situation (where possible).
People Plus Science work with the healthcare sector to establish, review, chair and mentor Patient and Customer Advisory Boards. We also provide psychological safety and culture assessments for health organisations supporting better clinical outcomes and safety for patients and well-being for staff.
Peh KQE, Kwan YH, Goh H, Ramchandani H, Phang JK, Lim ZY, et al. An Adaptable Framework for Factors Contributing to Medication Adherence: Results from a Systematic Review of 102 Conceptual Frameworks. J Gen Intern Med. 2021 Sep;36(9):2784-2795. doi:10.1007/s11606-021-06648-1.
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