What Is Therapeutic Adherence?

According to the World Health Organization, medical adherence is a problem to be taken into account. Indeed, the socio-economic damage resulting from poor adherence is incalculable.

The theme of therapeutic adherence is of great importance. Thus, the success of a treatment depends to a large extent on it. The question has a certain complexity because many factors affect this situation.

In fact, the first difficulty is the lack of consensus on the definition of therapeutic adherence. Some healthcare professionals view it simply as compliance with prescriptions. However, others see it as a multifactorial phenomenon.

In addition, the causes and consequences of the lack of therapeutic adherence are multiple. This means that each case is different. For this reason, it is not easy to understand or deal with this phenomenon. Let’s take a look at it step by step!

What is therapeutic adherence?

First of all, therapeutic adherence is the active and voluntary commitment of the patient in the treatment indicated by the health professional. Its objective is to obtain a specific result. In addition, this commitment must be agreed between the patient and the medical staff.

Therapeutic adherence refers to a set of behaviors. From the patient’s perspective, this includes accepting the treatment plan and practicing the indications effectively. On the other hand, it also includes avoiding risky behaviors and incorporating lifestyles in accordance with the therapeutic goal.

Then, from the doctor’s point of view, this first assumes the ability to forge a positive alliance with the patient. So, your instructor should give you clear instructions and make sure you understand them. Likewise, he must motivate the patient so that his adherence to treatment is voluntary.

Factors influencing therapeutic adherence

There are many factors that could either promote or hinder medication adherence. Among the main ones are:

• Doctor / patient interaction: this refers to the quality of the link. When it is positive, the adhesion is generally greater. So the essential factor is communication. The clearer and more reasoned the instructions, the better
• Treatment regimen: the most influencing factors are the complexity of the dosage and the side effects of the treatment. Also, single dose regimens are obviously the easiest to follow. On the other hand, the more side effects there are, the more difficulties there are
• Characteristics of the disease: when treatment quickly alleviates disturbing symptoms, adherence to therapy increases. Asymptomatic patients are those with poorer adherence
• Psychosocial factors: Beliefs, attitudes, lifestyle and values ​​are factors that facilitate or hinder adherence. Of particular importance is the perception of the effectiveness of the treatment and of the doctor.
• Environment: if the patient receives the support of his environment, it will be easier to follow the medical indications. Aspects such as religion and the attitude of the family towards health sometimes have a noticeable influence

Consequences of non-compliance

The lack of therapeutic adherence leads to multiple consequences, mainly clinical and economic. However, this is a difficult aspect to measure. Indeed, most patients avoid referring to their faults. They are usually not completely honest.

Thus, the clinical consequences depend on the type of non-compliance incurred. Sometimes treatment never starts, and in other cases, it is stopped early on. In addition, the effects will depend on the disease and the patient’s condition, among other factors.

In general, the lack of adherence also leads to an increase in healthcare costs. This leads to an increase in the number of hospitalizations and visits to hospital or emergency centers. On the other hand, it can also lead to prescription changes and an increased need for diagnostic testing.

How to achieve greater therapeutic adherence?

There is currently a lot of research being done on the design of strategies to improve patient adherence. Although the last word on this has not been said, the following measures are generally recommended:

• Simplify the prescribing regime as much as possible : the fewer doses of medication used, the easier it will be to obtain patient compliance
• Behavioral influence:  this includes actions to model patient behavior in relation to treatment. In addition, it includes reminders, follow-ups, rewards, etc.
• Educational aspects: the patient should know what to take and when. However, he must also know why it is important to do this. This allows him to voluntarily follow the prescribed diet without any pressure.
• Family and social support: this includes actions aimed at providing social support, such as home assistance, management of aid for the payment of medicines, etc. In addition, it involves interventions in the environment so that their involvement is greater.
• Training of health professionals:  above all, this is necessary for learning communication and motivation techniques

Therefore, all of these strategies must be applied simultaneously and in coordination. As this occurs, therapeutic adherence will be greater.