4 ways to encourage patient compliance, improve outcomes

When it comes to improving health, patients can be their own worst enemies by failing to exercise, stop smoking or take prescribed medications. This self-sabotage can be a drain on doctors' time and patience--but new techniques are emerging to help physicians communicate with noncompliant patients in a more effective way, American Medical News reported.

If you find yourself stymied about how to get patients to change their ways, consider the following strategies:

1. Quantify severity
Rather than merely suggesting that certain changes might help patients live longer, be direct about the consequences if they keep their behaviors the same. "When you turn up the dial a bit on the probability [of disability or death], it can get through," Yul Ejnes, M.D., a general internist in private practice in Cranston, R.I., told American Medical News.

"It's like when you're watching the news and they say the possibility of a hurricane strike is 60% instead of 10%. Well, at some point you say, 'We better bring in the yard furniture.'"

2. Let patients identify their own barriers 
First developed in the 1980s to counsel patients with substance addictions, the idea of motivational interviewing is catching on among all types of physicians working to tackle lifestyle-related illness. Rather than taking a traditional paternalistic approach, ask more open-ended questions, advised Kim L. Lavoie, PhD, who has trained more than 5,000 physicians and other health professionals in motivational interviewing.

In general, this technique devotes less time to lecturing or interrupting patients, and more to summarizing what patients are saying about the challenges they face, and encouraging them to develop solutions that work for them.

3. Address depression
"Cognitively, if I'm so depressed, then my ability to positively appraise my situation is dampened," said Gbenga O. Ogedegbe, M.D., director of the Center for Healthful Behavior Change at New York University School of Medicine.

"If that's dampened, it follows that my confidence, judgment and capability to carry out the desired task is impaired."

4. Leverage allied staff and technology
A major challenge to overworked physicians in engaging patients, of course, is time pressure, noted an article from Medical Economics. The article cited a recent study from Health Affairs, which concluded that physicians need better training in shared decision-making, smarter technology to save patient preferences in their electronic medical records and possibly more clinical staff to work with patients on addressing behavior change.

To learn more:
- read the article from American Medical News
- see the story from Medical Economics
- check out the abstract from Health Affairs

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