The nurse can use a variety of interventions to help the patient improve adherence. Here are some helpful strategies:
- Ask the patient why he or she is not able to follow treatment recommendations. The patient’s view of why adherence is difficult is the one that counts.
- Try to avoid proposing an immediate solution. Focusing your efforts on helping the patient learn problem-solving skills will be of much greater benefit in the long run.
- Determine whether the patient believes that adherence will help solve the health care problem. If the answer is „no,“ find out patient’s beliefs about the problem.
- Does the patient understand what to do? It’s difficult for adults to admit they don’t know how to do something. Often, if people are not sure of what they are doing, they will often do nothing rather than risk doing something wrong. For example, to determine that a patient knows how to take medication, ask the patient to tell you exactly what he or she is going to do-take how many tablets, at what time, with/without food, and what side effects to look for.
- Determine that the patient has the skills to adhere. Does the patient have limited hand function or visual problems that will make adherence difficult?
- Is adherence punishing? For example, some drugs have uncomfortable side effects or an exercise program may cause stiffness.
- Is the new health care behavior too complex? Sometimes we ask patients to do many skills at the same time. Analyze everything you are asking the patient to do and simplify tasks if needed.
- Does the patient have a memory problem that interferes with compliance? Using memory aids to recall when to take medications or linking the new behavior with an already established activity can help.
- Does the patient have the mental capacity to learn the required health care management skill? If not, locate a spouse, family member, or neighbor to help the patient. Many older people who live alone are part of an informal helping network of friends and neighbors. Members of that network can be encouraged to call the patient regularly to remind the patient what he or she is to do.
- Does the patient have the physical capacity to do the skill? If not, simplify the activity or provide assistance in the form of assitive devices or support help.
Adherence to health care recommendations is a major issue in health care today. Nurses and other health care professionals tend to believe that informing a patient about what to do will result in the patient following treatment recommendations. However, research shows that a large number of patients don’t follow the treatment recommendations and health care instructions we give them. By making patients more active partners in care and by forming closer interpersonal relationships with patients, nurses can help solve this significant problem.