Adherence: transforming cure into care

April 2017

Within the field of medical adherence, we become equipped with the phrases to explain the importance of what we do. We learn the chorus: approximately 50% of patients do not take medicines they are meant to; communication barriers between clinicians and patients can leave adherence unaddressed; poor adherence leads to increased morbidity and mortality. Swimming in p values and questionnaires and segmentation, it is sometimes easy to forget the worth of empowering patients by investigating non-adherence to our patients.

The need for patient empowerment is echoed throughout healthcare and we know that involving patients in conversations about adherence is part of this. Many of the constructs that define patient empowerment, such as personal control and self-efficacy, are synonymous with the theories behind Spoonful of Sugar (SoS) frameworks that measure and understand adherence. If knowledge is power, then our frameworks enable us shape adherence programmes in a way that responds to and gives weight to our patients’ needs and values. But what worth does this hold for patients?

By listening to what patients think about their medication regime, we add value to how patients feel, and appreciate how complicated this can be. As someone whose medical files are laced with finger-tip-unit-only steroids, count-to-five-between-puffs inhalers, and “I nag because I care” relatives, it is comforting to know that adherence studies humanise us. Our researchers remove the fear of stigmatising labels such as “lazy”, “ignorant” and “ungrateful” by understanding the complexity of behaviour. Our approach breaks down the “them” and “us” wall between healthcare professionals and patients. We encourage empathetic care and create opportunities to share repressed worries and frustrations. Our knowledge of adherence does empower patients, but ultimately, we ensure cure is transformed into care.

There is no p value to measure the relief we feel when we can voice our thoughts on our treatment, but the significance of being understood cannot be over stated.