Dr KK Aggarwal
A new research reports that low-income patients with high
blood pressure are less likely to take their medications as directed if their
healthcare providers do not use a collaborative communication style or ask them
about social issues.
The three-month study published in the journal Circulation:
Quality and Outcomes examined the impact of patient–provider
communication on medication adherence among a sample of primary care providers
and their patients who had hypertension. Most of the participants were black,
unemployed and reported some college education. The study found that:
· Patients were three times less likely to take their high
BP medications when their providers did not possess a collaborative
communication style such as asking open-ended questions and checking their
understanding of instructions.
· Patients were also six times less likely to take their
medications as prescribed when a healthcare provider did not ask them about
social issues such as employment, housing and partner relationships.
This study demonstrates the negative impact of poor
communication on adherence to treatment and highlights the need for better
doctor-patient communication to improve compliance to treatment and achieve
desired treatment outcomes. The study says that “such discussions signal to the
patient genuine caring and concern by the doctor, which strengthens patient’s
ability to cope with their life and illness, along with motivation and
confidence related to self-management of their disease”.
Listening is very important skill for doctors. The
concerns of patients should be addressed without being judgemental. Therefore,
in addition to prescribing medicine, doctors should also take note of the
social determinants of health when managing their patients, as they have
significant role to play in the health and wellbeing of the patient.
Patients want support and encouragement to take their
prescribed medications, especially in case of chronic illnesses such as
hypertension, diabetes, heart disease, etc. They either often forget to take
their medication or may not realize the need for adherence to treatment.
Low income patients usually may not be well educated. This
group of patients must be explained the need of compliance to the treatment
prescribed. They have to be educated about the disease and why medication is
important. This reassures the patient and he/she is motivated to follow your
instructions more willingly.
On the other hand, high income patients sometimes may be
too busy to remember to take their medications. It may not be a priority for
them, at that time. Adherence to medications in such high income patients can
be improved by SMS reminders.
As Sir William Osler famously said, “The good
physician treats the disease; the great physician treats the
patient who has the disease.”
(Source: AHA News Release, August 22, 2017)
Disclaimer: The views expressed in this write up are
entirely my own.
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