Is There a Treatment for Patient Non-Compliance?

June 16, 2011
Gregory Steinberg, MD

Patient compliance is not a new issue – doctors have been dealing with it for a long time now, and it’s not going anywhere. But as the healthcare landscape changes and we continue looking for ways to improve patient outcomes and reduce costs, non-compliance presents a significant hurdle.

A Consumer Reports survey of primary-care physicians earlier this year found that their top complaint was patients not complying with their advice or treatment recommendations, with about 37 percent saying it affected their ability to deliver the best care by “a lot.” 

Patient compliance is not a new issue – doctors have been dealing with it for a long time now, and it’s not going anywhere. But as the healthcare landscape changes and we continue looking for ways to improve patient outcomes and reduce costs, non-compliance presents a significant hurdle.

While the responsibility to address compliance does not rest solely on doctors’ shoulders, there are some effective strategies and tools that doctors can use to help improve patient adherence. Physicians Practice has a great article, “Patient Compliance Techniques That Work,” that closes with a summary of some strategies, including:

• “Customize treatment plans to help patients manage their own care;
• “Use new software products to help create compliance programs;
• “Communicate both verbally and in print to drive your message home; and
• “Tap into your patient's emotional needs”

While technology is only one piece of this puzzle, it is an important one to consider. Today, new technologies offer doctors an array of tools to support patient compliance and engage patients in their own health. Of course, there is not a one-size-fits-all piece to this puzzle. But doctors can consider the following technology categories and encourage patients to take advantage of the tool that best fits their situation and needs.

Apps are a category that doctors should consider learning more about and recommending to their patients. There are thousands of innovative health apps available for smart phones and tablets, which can help patients manage an impressive variety of conditions - everything from obesity and hypertension, to coronary artery disease and diabetes. As an added bonus, many also enable patients to monitor their health and vitals. And there are even apps for caregivers.

Patient portals are another great tool, if you have the infrastructure already in place. These personalized member engagement websites can provide patient-specific information and tools, as well as allow the patients’ care team to send helpful reminders and positive messages. These portals also enable patients to access their own health records, communicate with their care team and take advantage of resources like health screenings.

Clinical alerts or messages to patients and physicians can also be effective. Typically an output of clinical decision support, clinical alerts can identify potential opportunities to improve patient care, such as identifying potential drug interactions, a recommended screening or diagnostic test.

Compliance devices are another option, especially for less technology-savvy patients. Manufacturers are developing a range of these products, including such items as key ring alarms, electronic pill dispensers and vibrating watches. And some of these devices get very “smart,” like pill dispensers that can notify providers if a patient misses a dose of their medicine.

Patient compliance can be a real challenge, but these tools are one way to help alleviate some of the pain. Do you have a favorite app or technology tool that you’ve found effective in your practice? Feel free to share in a comment.

Gregory Steinberg, MD, is a cardiologist and internist who previously served as the associate director of medicine and director of clinical education at St. Lukes-Roosevelt Hospital Center in New York. He is an associate clinical professor of Medicine at Columbia University and a senior attending emeritus at St. Luke's-Roosevelt Hospital Center (SLRHC) in New York City. He currently serves as CEO and president of ActiveHealth Management. E-mail him here.