Enhancing Treatment Adherence

Adherence and patient compliance can play a critical role in treatment effectiveness. Ahead, experts share their pearls for working with patients to get the best outcomes possible.WHEN DEVISING A TREATMENT PLAN, WHAT STEPS DO YOU TAKE TO TRY TO ENHANCE PATIENT COMPLIANCE?
In devising a treatment plan, it is important to make it simple, explains Mark Bechtel, MD, Professor of Dermatology-clinical, Department of Dermatology, University of Pennsylvania. He says you should minimize the number of medications and frequency of application and try to avoid irritating medications initially. “Over time, the treatment plan can become more complex. Compliance is enhanced if the patients are aware of the treatment options and play a role in the treatment selection,” he advises.Gary Goldenberg, MD, Assistant Clinical Professor, Dermatology, Icahn School of Medicine at Mount Sinai, Medical Director of the Dermatology Faculty Practice, says he makes sure to explain the diagnosis in a language the patients can understand. “We talk about treatment options and I usually will present one or two that I think are viable and make sure the patient is part of the decision making process,” adds Dr. Goldenberg.Andrew C. Krakowski, MD, a pediatric dermatologist at Rady Children’s Hospital, in San Diego, CA, says he actually prefers the term concordance over compliance. Compliance “implies, too much, a paternalistic relationship—one in which the physician instructs the patient to follow a specific regimen and then expects it happens, only to be disappointed when it does not. That sentiment is particularly striking when you read studies that suggest our patients may only be filling one out of every three prescriptions we write,” says Dr. Krakowski. He says concordance suggests that through a partnership between the patient and the physician a mutually agreed-upon regimen can be implemented and long-term success can be achieved. “This model, from the start, considers factors such as selecting a vehicle that works for everyone (choosing an ointment versus a cream, for example); financial cost of prescriptions; ease-of-use of the overall regimen; and side effects—both anticipated and unexpected.”Read more at Practical Dermatology.