In a world where immediate access to information is ubiquitous, it might seem strange that low patient understanding is still a front running influencing factor in patient adherence – but there is evidence to show this might be the case. In fact, a lack of understanding, or a misunderstanding, of a disease and its treatment, combined with a lack of patient confidence in their ability to self-manage, can be compounding factors in low patient adherence.
At Mash we are all about the “Why?” So, why, when information is theoretically so easily accessible, is patient understanding so low?
This problem is often attributed to the fact that many physicians (the leading influencers in adherence according to a recent Capgemini report) are restricted in the amount of time they have available to diagnose patients, let alone educate them on the benefits of self-management and compliance.
But, taking the UK as an example, between 1992 and 2007, primary care physicians actually increased the amount of time they could spend with patients, with the average doctor-patient consultation in England now lasting around 11 minutes. But is increasing the amount of time spent with patients what is needed to increase patient adherence? We feel that in a system where up to 40% of orally treated cancer patients are non-compliant, the problem must be deeper than a simple matter of consultation length.
A recent US study showed that physicians tend to overestimate the amount of information they provide a patient, and underestimate the amount of information a patient would like, during a consultation. In reality, the average doctor only spends 49 seconds discussing a new medication with a patient – a fact which is unlikely to change as a result of minimal increases in face-to-face time. With those statistics in mind it is perhaps less surprising that the recent Capgemini report suggested that up to 50% of patients leave a consultation unsure of their physician's instructions.
To really address the understanding=adherence problem, the attitudes of the healthcare industry towards medication education within the confines of a consultation need to be addressed. Practitioners require the means to understand their patients’ educational needs and the tools with which to address the knowledge gap. Patients, for their part, may need to adjust their expectations regarding what they need to know from their doctor, and what they are able to educate themselves on – and will consequently need adequate support to self-educate and self-manage.
Therefore, the problem of adherence is not a question of time, but a matter of communication and how that time is used to effectively communicate with a patient to satisfy the evolving requirements of a consultation: to provide not just a diagnosis but also the education needed to enhance patient adherence. But that is a topic for another blog...
Account Executive
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