Getting patients to adhere to treatment in COPD is often easier said than done. At times, treatment may require a different approach. Discover how these little known tips can help you understand your patients on a deeper level and influence adherence at the same time.
Achieving adherence to treatment in COPD can be tricky. When patients are asked why they are nonadherent, they often give practical answers: “My oxygen device is too noisy. Too big. Too uncomfortable. It’s embarrassing to lug around. It limits my ability to live my life.” Even trickier are the answers from patients who may not know how to cope with the reality of their nonadherence: “I’m doing great. I have no complaints and nothing to change.”
So what happens when you solve these practical drivers and still find your patient is nonadherent? How can you dig deeper and learn what’s important to them? And, how can you turn their ambivalence toward adherence into an overwhelming air of confidence?
We have you covered. Let’s explore some little known tips to treatment that can help you understand your patients on a deeper level and influence adherence in the process.
Global Lead, Health Behavior Change
Philips HealthTech
Change is hard. And when you’re asking patients with COPD to change their behavior to bear the burden of therapy, it’s especially hard. It’s easy to talk about what’s relevant to you and focus on your own perspective. But, this often doesn’t help you understand patients on a deeper level or speak to their value system. That’s why it’s important to recognize the need to adapt to their changing needs.
If we want to build confidence in creating change, we need to start with physicians.”
Global Lead, Health Behavior Change
Philips HealthTech
If we want to build confidence in creating change, we need to start with physicians.”
Restate what your patient is saying to show you are listening
Summarize the problems they’re experiencing to make sure you’re fully understanding what they are telling you
Encourage them to keep speaking with brief positive prompts such as, “I understand”
Validate their problems, issues and feelings by responding with empathy
PAUSE may be a valuable technique when listening and speaking with your patients:
Personalization—understand what their personal goals are and tie in a behavior that helps them meet their goals
Autonomy—adherence is a personal choice that must be made by each patient alone. While you can emphasize the value of it, don’t push too hard. Focus rather on guiding your patients and helping them take ownership over their own choices
Urgency—create a sense of urgency to adherence based on their value system
Social support—suggest groups that your patient can join that will help reinforce adherence to treatment
Empowerment—build confidence in your patient by setting reachable goals and highlight their success each time they achieve one
To create urgency, it’s important to know when to take your foot off the gas, because when we do that patients tend to put their foot on it and take ownership.”
Global Lead, Health Behavior Change
Philips HealthTech
The reality is, you may only get to see your patients a few times a year. This gives you a small window to reinforce adherence and help them meet their goals. Although your time is limited, there may be another way to help maximize their chances of adherence. It involves talking to the people who are with them the most: their family.
Family members need to be approached and taught the right way to help with adherence. If not, their dialogue can come across as nagging or belittling, which can be counterproductive to adherence.
Getting patients with COPD to adhere to treatment doesn’t happen overnight. And, at times it may seem like quite the uphill battle. But, there’s hope. By strengthening your ability to change, actively listening and enlisting the help of a support system, adherence may become a constant in your patient’s life. And your goal of keeping patients healthy at home is one step closer.
References:
1. Sperry L. Motivational interviewing, nonadherence to medical treatment, and families. Fam J Couns Ther Couples Fam. 2012;20(3):306-308.
2. Bourbeau J, Bartlett SJ. Patient adherence in COPD. Thorax. 2008;63(9):831-838.
3. Decramer M, Nici L, Nardini S, et al. Targeting the COPD exacerbation. Respir Med. 2008;102 (Suppl 1):S3-S15.
4. Jahromi VK, Tabatabaee SS, Abdar ZE, Rajabi M. Active listening: the key of successful communication in hospital managers. Electron Physician. 2016;8(3):2123-2128.
5. Grohol J. Become a Better Listener: Active Listening. PsychCentral Web site. https://psychcentral.com/lib/become-a-better-listener-active-listening/. Published May 17, 2016. Accessed June 2, 2017.
6. Bryant J, Mansfield E, Boyes AW, Waller A, Sanson-Fisher R, Regan T. Involvement of informal caregivers in supporting patients with COPD: a review of intervention studies.
Int J Chron Obstruct Pulmon Dis. 2016;11:1587-1596. https://www.qualitymeasures.ahrq.gov/summaries/summary/49195/chronic-obstructive-pulmonary-disease-copd-hospital-30day-allcause-riskstandardized-readmission-rate-following-acute-exacerbation-of-copd-hospitalization. Published October 1, 2015. Accessed June 1, 2017.
