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Treatment Adherence

How closely patients follow a prescribed treatment regimen affects how well they respond to treatment. Key components of a patient's improvement include their willingness to start treatment and the ability to take medications exactly as prescribed.

Taking one’s medication to reduce heart disease has been shown to lower one’s risk factors and reduce heart disease-related deaths for patients. Adherence to medications for chronic diseases such as diabetes and high blood pressure is a challenge for all patients of any race race or ethnic background.1   Between 10-30% of persons who have diabetes do not follow the routine prescribed by their doctor within a year. Also, people’s long-term use of medicine to control their high blood pressure is not consistent.

There are many reasons that a person may not be consistent with his/her treatment. A patient may not have enough money to pay for medication, or they may not feel ill, leading to a belief that medication or treatment is not needed. And still others may have other priorities that they deem more important than adhering to treatment.

One of the barriers that should be seriously considered is the relationship between the physician and the patient. Generally, African Americans and Hispanics are less likely to trust medical providers and more likely than whites to believe that they would have received better health care if they belonged to a different racial and ethnic group.2 

Many patients of color receive a poorer quality of interpersonal care, (asociated with stereotyping, miscommunication and language barriers) from doctors than whites.3  This may contribute to the problem they have taking their medication regularly. A breakdown in communication also may result in shorter office visits that are less patient-friendly than those for white patients.4 

Good relationships between patients and their medical providers are important if the patients are going to follow medical advice and take their prescribed medicines. If patients feel confident in their medical provider and feel that they share good communication, they are more likely to stay on their course of treatment.

Treatment Adherence Resources

National Heart, Lung & Blood Institute
http://www.nhlbi.nih.gov/hbp/treat/treat.htm

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1Traylor AH, Schmittdiel JA, Uratsu CS, Mangione CM, Subramanian U. June 23, 2010. Adherence to cardiovascular disease medications: Does patient-provider race/ethnicity and language concordance matter? http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2947630.

2Johnson RL, Cooper LA. Racial and ethnic differences in patient perceptions of bias and cultural competence in health care. Journal of General Internal Medicine 19: 111-119;101-110, 2004.

3Institute of Medicine. Unequal treatment: What healthcare providers need to know about racial and ethnic disparities in healthcare, March 2002.

4Cooper LA, Roter DL, Johnson RL, Ford DE, Steinwachs DM, Powe NR. Patient-centered communication, ratings of care, and concordance of patient and physician race. Annals of Internal Medicine 139: 907-915, 2003.

Treatment Adherence
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