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.