Adherence to treatment: why the program is abandoned

When it comes to implementing psychological or pharmacological treatments, not everything depends on the experience and willpower of doctors or psychologists. In fact, there is a potential problem capable of making the entire plan to achieve cure or remission of symptoms fail: lack of adherence to treatment.

The truth is that many times the improvement in the health of patients is interrupted (or does not reach start) because they decide to abandon the intervention program, or only partially comply with it, for example, forgetting to take your pills too often or not practicing the exposure technique in case you want to control a phobia.

However…what we know about adherence to treatments And to what extent can the non-abandonment of these be promoted?

• You may be interested: "The 10 most effective types of psychological therapy"

Why it is important not to abandon treatment

In the face of certain medical problems, it is important to follow the treatment in a disciplined way if you do not want to fall at risk of suffering severe damage to health, or even death. However, even if the consequences do not have to be serious, lack of adherence to treatment

always produces negative consequences. The main ones are the following:

Increase in healthcare spending

The resources, efforts and time that are invested in initiating psychological or medical treatment are wasted if the health improvement program is abandoned.

Subjective discomfort

Although some diseases and disorders disappear or remit without the need for intervention, in many cases the lack of adherence directly generates increased discomfort or, directly, there is no improvement.

Appearance of idea of ​​ineffectiveness

Some patients interpret their own abandonment of treatment as a failure of this, which makes the negative feelings they experience later due to the lack of palliative or curative measures are perceived as ineffective by the healthcare team.

Is lack of adherence to treatment common?

From what is known from the numerous investigations carried out on this topic, the lack of adherence to treatments is one of the serious problems that any system must face sanitary.

In fact, about half of people with chronic diseases and disorders decide to stop treatment or forget about it. What's more, almost three-quarters of people stop following preventive programs, and almost a third of people with non-chronic health or psychological problems do the same with measures designed to improve their condition.

The profile of the people most likely to abandon treatment is that of someone with a chronic problem who must make significant changes to her lifestyle. For example, someone with Bipolar disorder Who has been recommended, among other things, to keep a diary and to consider in the mornings and afternoons how they can better manage their personal relationships.

The opposite occurs in those people who, in the face of an acute health problem or a specific psychological crisis, must assist the clinician to directly apply the treatment. This tendency not to stop collaborating with the health program it is greater if the improvement of symptoms occurs quickly.

How to get patients to commit?

These are some measures that have been shown to be effective in preventing lack of adherence to treatment:

1. Constant comunication

The therapist-patient bond must be fluid and based on good rapport. This means that any doubt must be resolved and that space must be left for the patient to ask her questions and express her insecurities.

• Related article: "Rapport: 5 keys to creating an environment of trust"

2. Offer an individualized treatment

To prevent problems that may arise, it is necessary to know, even in a superficial way, what is the lifestyle of each patient, and their beliefs or level of knowledge about your problem. For example, if at home there are prejudices against drug-based treatments.

3. Start treatment with another desirable habit

To make the change perceived as something positive, it is possible associate it with a better lifestyle and healthier in the eyes of each patient. For example, the same day that the first pill is taken, start with a much healthier diet designed to improve general health.

This also allows you to create a compensatory mechanism. For example, someone who believes that taking a capsule in the morning will not produce great effects may interpret it as part of the routine that involves starting drinking a glass of water, or you can understand that it is a healing proposal that is combined with another that is better tolerated, covering all intervention fronts sanitary. In this way, a global improvement is used, without leaving blind spots.

4. Motivate through other mechanisms

In certain special contexts it is possible to use programs to reinforce adherence to treatment. For example, the use of the Token Economy, which can be used at home, in educational centers or in hospitals.