Why do patients discontinue or do not follow treatment properly and how you can avoid them?

Why do patients discontinue or do not follow treatment properly and how you can avoid them?
By Dr Maharaja SivaSubramanian N

One of the reasons of the health-care system not being in a completely optimal level or rather in a bad shape can be said as the non-adherence of the patients with the treatment. Non-adherence can be either not following the treatment completely or at varying degrees or discontinuing the treatment completely as such. In such scenarios the following can be said as some of the reasons why patients do not follow the treatment properly and in such instances it is advised that the patients take remedial actions as given below.
The various reasons for patients having non-adherence are;
Forgetfulness.
Being away, from home or from therapist.
Being busy.
Treatment procedure resulting in disturbances with daily routine.
Treatment resulting in discomfort in terms of convenience.
Costly procedure.
Perceived shortcomings and absence of immediate relief.
Work schedule.
Expecting of attender or caretaker and/or absence of them.
Lack of support from family.
Lack of psychological motivation.
Lack of knowledge.
Complex regimen.
Anxiety about treatment side-effects.
Absence of proper therapeutic relationship with the Doctor.

Forgetfulness. Patients forget their medications to be taken. And if you are one having this problem, then you can start with maintaining a remainder for yourself to take medicines on time. Because when you a skip one instance of medication, then it might actually require two or more instances of medication in future. Set yourself a remainder which can be in the form of written notes, alarm, calendar entry, or someone reminding you.

Being away, from home or from therapist. Whenever you are planning to be away from home, always make sure to carry your medications along with you. If you may have unexpecteed needs to travel, then maintain a copy of the prescription with you always as all medications can be purchased in most of the places when you have a valid prescription. If you stay away from therapist, then look for other ways by which you will not skip the treatment which can be like asking the therapist for a home visit for consultation, asking the therapists for suggestions of therapists who live nearby to your home, getting a online or virtual consultation, etc.

Being busy. If you are busy enough that you don’t have time to focus on your health, you are doing more harm for yourself.

Treatment procedure resulting in disturbances with daily routine. If the treatment procedure is disturbing your daily routine, speak with your therapist to schedule the treatment in an appropriate way where it will not disturb your daily routine.

Treatment resulting in discomfort in terms of convenience. Not all treatments are inconvenient. Sometimes, yes there are treatments which can result in inconvenience. In such instances, speak with your Doctor, get help, find if you  can reduce the inconvenience to a greater extent.

Costly procedure. Cost factor is one of the important factors in present day health care system. Check out if you can avail insurance, does your office have medical reimbursement, and better still, start taking preventive measures and become healthier from beginning and you will avoid medical treatment and also the cost associated with it. Remember, prevention is not only better than cure, it is also costs less as compared to cure.

Perceived shortcomings and absence of immediate relief. Certain treatment methods work beyond providing immediate relief. However, all therapists are sensitive and empathatic to the needs of the patient/client and strive to provide immediate relief. This may not be to the expectation to the patient sometimes, however, this should not be taken in as a reason for discontinuing treatment.

Work schedule. Work is important and more so is health. If you are not healthy, then where is the question of engaging in work and be productive for longer period of time. Many a times, you may be forced to take in early retirement. So, if your work schedule does not permits proper adherence to the treatment, then speak with your Doctor/Therapist. I started online consultation based on my experience with patients who had diffiult work schedule. Through online consultation, I could see patients/clients even at midnight (24 hours to be precise) on prior appointment.

Expecting of attender or caretaker and/or absence of them. Most of the patients do need attender or caretaker. Not having one can be highly negative in terms of treatment progress. Health care industry has taken notice of this and in order to fulfill this need, many attenders or nursing assistants are being trained to provide personalised care for patients.

Lack of support from family. Family support is very important. Many a times, the family may not understand that your treatment is vital for you. In such instances, ask the therapist to interact with your family and explain them about the support needed for the treatment. Taking into consideration, this major need was one of the major reasons why I started with home visit.

Lack of psychological motivation. Motivation plays a major role in treatment. And more so is the rising importance of psychological counselling where the patient and their family needs to be counselled. Many Doctors have understood this importance and are currently undergoing training in psychology. I sensed the need early in my student career and hence along with my medical training, I also had my psychology training.

Lack of knowledge. Many Doctors don’t have the time to sit and discuss with the patient. And as such, they also are not able to give enough information to the patients. During my medical internship days, I saw that many patients were discontinuing treatment because of not having adequate knowledge. To take care of this need, I started this blog where I periodically update the knowledge of my patients and also public. I also answer questions and clarifications to be answered for the patients by phone and email and also in person whenever I meet. A lot of public forums are also working well in this model by getting Medical and Health care professionals to give lectures in their organizations. Periodicals also cover health articles frequently.

Complex regimen. Sometimes the patient/client feels the whole treatment procedure to be complex and hence discontinues the treatment. This is a lot because of communication problem. To resolve it, the patient/client needs to be encouraged to ask for any clarifications needed and should be checked if they have understood the treatment procedure and are able to follow the treatment procedure easily by the Doctor/ Therapist.

Anxiety about treatment side-effects. Certain treatement procedures do have side effects and if you are worried about them, speak with your Doctor. Information is also available online where you can search for possible side effects of treatment method and/or medication. Always know the positive effects and the side effects of treatment procedures and then begin with the treatment.

Absence of proper therapeutic relationship with the Doctor. Failure to build a proper relationship between the Doctor and the patient or the therapist and the client results in lots of treatment drop-outs. Both the Doctor/Therapist and the Paitent/Client must take sufficient steps and effort to ensure a proper relationship between them.
Be Healthier and Happier. Become Empowered and Enriched.

Dr Maharaja SivaSubramanian N

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Dr Maharaja SivaSubramanian N is India’s 1st Holistic Concierge Medicine Doctor specializing in Homoeopathy, Counselling, Hypnotherapy, Nutrition, Exercise Therapy. Contact Dr Maharaja N for your treatment needs. 

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