Optimizing the Physician-Patient Relationship and Educating the Patient About Adherence

Abstract

Optimizing the physician-patient relationship is perhaps the most fundamental piece of the adherence challenge. Physicians who evoke feelings of trust, confidence, and empathy from their patients are more likely to observe good patient adherence [1]. Although the term “compliance,” based on a paternalistic view of the clinical encounter, is now considered outdated, the regimen is still suggested by the physician more often than not. Patients who want to please their physician are likely to be more willing to make an honest attempt to perform the treatment regimen correctly. Starting off well, and consequently seeing early improvement in disease, is likely to lead to higher satisfaction and long-term adherence [1, 2]. In contrast, patients with negative feelings toward their physician are likely to be more influenced by fears, temporary setbacks (such as side effects), and gradual loss of patience with the regimen, which are all major reasons for poor adherence and early discontinuation. Trust is also a two-way street, influencing the reliability of communication from the patient to the physician as well [3]. With a better rapport, it is more likely that patients will honestly admit areas of concern, and physicians will gain better information to produce good decisions.