Tag Archives: compliance

When “nudging” doesn’t work to change patient behaviour

12 Nov

by Carolyn Thomas     @HeartSisters

CAROLYN’S WARNING: this article contains a C-word that drives many chronically ill patients stark raving bonkers. Continue reading only if you can stomach the word “COMPLIANT”

Dr. Aaron E. Carroll wrote a compelling essay in the New York Times recently. (By the way, I’ve often wondered why so many people – mostly men, I’ve observed – insist on formally using a middle initial? Is it to differentiate them from all of the other Dr. Aaron Carrolls out there?)*

Dr. Aaron E. Carroll’s subject has intrigued me ever since 2008 when I was told in the CCU that, from now on, I needed to take this fistful of new cardiac meds – many of them every day for the rest of my natural life. And pesky patients who, for whatever reason, do not follow doctors’ orders represent a perennial frustration in medicine. Sometimes the consequences of not being “compliant” (or “adherent”, the slightly less patronizing term) are brutal, so this decision not to can be deadly serious, accounting for two-thirds of medication-related hospital admissions. And more to the point, it begs the question of how to convince people to do what the doctor says they must (or, as some people – but not me – like to call it: “how to make non-compliant patients compliant”). Continue reading

First, there was compliance. Then, adherence. Now, concordance!

16 Jul

by Carolyn Thomas     @HeartSisters

Non-compliant patients who, for whatever reason, do not follow doctors’ orders are a pain in the neck to their physicians. But to me, the most problematic part of that statement is the use of the word non-compliant. Simon Davies of the U.K.’s Teenage Cancer Trust once described it as “a word that sounds like it has punishment at the end of it.”  Yet physicians are frustrated about why so many of us refuse to take their expert medical advice. Continue reading

Patient engagement? How about doctor engagement?

9 Apr

by Carolyn Thomas  @HeartSisters

It’s a stressful time to be a patient these days, what with expectations running high that we should be both empowered and engaged while self-tracking every trackable health indicator possible – and of course retaining an all-important positive mental attitude – in order to change health care forever. 

Whew. I had to go have a wee lie-down just thinking about how big that responsibility may seem on days when we patients are feeling, yes, sick –  as an annoyingly significant number of patients living with a chronic and progressive illness tend to feel on any given day. That’s why we’re sometimes called “patients”.   Continue reading

Why don’t patients take their meds as prescribed?

13 Dec

by Carolyn Thomas  @HeartSisters

Compliant is one of those words that makes my skin crawl. It’s the word that our doctors use to describe good patients who take their prescribed medications exactly as ordered. The Teenage Cancer Trust’s Simon Davies in the U.K. once described the C-word (and its ever-so-slightly less patronizing alternative adherent) as words that “sound like they have punishment at the end of them.”

But for most physicians, both words mean the same thing: a serious health care issue. That’s because when patients refuse or stop taking the medicine their doctors have prescribed to help manage a serious medical condition, the consequences are often devastating.  From organ transplant recipients to those living with chronic diagnoses like diabetes, heart disease, epilepsy, HIV or Hepatitis C, those consequences can be swift and sometimes even fatal.  Continue reading

My lowly beginnings as an empowered patient

16 Sep

by Carolyn Thomas  @HeartSisters

I still remember the day when it all began. I was very sick (don’t remember exactly what the sickness was, because I was only about five years old at the time). But I was sick enough for my mother to call our family physician, Dr. Zaritsky, who came right over to the house to see me.  (Yes, that is how old I am. I actually do remember when family docs made house calls).

Dr. Zaritsky declared that I needed an injection to treat whatever was ailing me, but – horrors! – the injection was to be done by pulling down my pajama bottoms and jabbing me right in the bare bum.

I was outraged!   Continue reading