Treatment adherence: Working as a team with your healthcare professionals

People living with a chronic disease must often take medication or make lifestyle changes in order to control the symptoms of their disease or prevent its possible complications. They have to do this long-term, or even for the rest of their lives.

In order to achieve treatment objectives, patients must work with their healthcare team and commit to following their recommendations. This is important because even if healthcare professionals make a correct diagnosis, prescribe the appropriate treatment and give the necessary recommendations to their patients, the desired benefits won’t be achieved if patients don’t follow the recommendations!

First step: Agree on a treatment

When prescribing a treatment, healthcare professionals make their choice based on official medical guidelines (developed through clinical studies), as well as personal experience and their patient’s specific situation and characteristics.

Some people accept the recommendations without questioning, trusting their healthcare professional’s judgment. Others are reluctant to take medication, follow recommendations or make lifestyle changes, for various reasons (e.g. bad past experience with medication, the impression that the treatment won’t work, or the fear that it may cause some harm).

Don’t hesitate to share your questions, concerns and expectations with your healthcare team. If you do so, they will have a better understanding of your situation and can make adjustments, when possible. If you need more information on your treatment, speak to your healthcare professionals, rather than going on the Internet. It can be difficult for laypersons to recognize which sites offer biased (or sometimes downright false) information, or to fully understand the medical information contained in certain sites. If you want quality information, you can consult the sites of official associations (e.g. Diabetes Quebec, the Arthritis Society, or the Canadian Cancer Society).

Second step: Respect the recommendations on a daily basis

You’ve taken the time to speak to your professional, and you’ve agreed to follow the recommended treatment. The ball is now in your court, although your healthcare team is still there to support you. Official associations also offer support groups that can be of great help.

If you need to take medication, make it part of your daily routine, so that taking it becomes a habit. There are several strategies for remembering to take medication, such as associating it with a daily task (e.g. brushing your teeth), using a pillbox, or setting an alert on your smartphone.

If you’re having problems taking a medication, or if you’re experiencing any adverse effects, let your pharmacist know right away. Adverse reactions that occur early in a treatment are often temporary and disappear after a few days. A slight adjustment is sometimes all it takes for everything to settle down. 

Treating a chronic disease is rarely just a matter of taking medication. Healthcare professionals usually recommend other measures, such as dietary changes, weight loss, quitting smoking, or doing certain exercises. These measures are often the ones that are perceived as the most difficult to integrate. And yet, they can have a major impact on the management of the disease, and your health in general.

For example, did you know that many chronic diseases, such as type 2 diabetes and hypertension, are linked to obesity? By losing weight, it is sometimes possible to avoid taking medication or reduce the dose required to control the disease.

The various aspects of the treatment can be integrated one at a time, to facilitate the process. For example, if the doctor has recommended losing weight and quitting smoking, in addition to drug therapy, it’s best not to tackle all of these measures at once, as it could be overwhelming. Speak to your doctor to determine which measure is the most urgent. If it’s dietary changes, then you can think about quitting smoking once your drug therapy is stabilized and you’ve successfully implemented the changes to your diet. This may not be for a few months, and that’s fine. The important thing is to find a balance that works for you.

Third step: Continue the treatment as long as necessary

A chronic disease, by definition, is a disease that cannot be cured. However, it can be controlled in order to improve the patient’s state of health, and to reduce or delay any complications. This means that the treatment and complementary measures are lifelong commitments.

It’s important to understand that controlling a chronic disease does not mean it has been cured. For example, if you suffer from hypertension and you achieve normal readings after a few months of treatment, this does not mean your hypertension has been cured, but rather that the treatment is effectively controlling it. If you stop taking it, your blood pressure will increase again, as will your risk of complications, such as having a stroke or heart attack.

If you’re not sure you still need to be taking a treatment, discuss the matter with your healthcare professionals. This will allow them to understand the reason for your concerns, and find a solution. It’s important not to stop the treatment on your own, particularly because many treatments must be decreased gradually.

And what if my condition is not chronic?

The three steps of treatment adherence are the same for all treatments, regardless of whether they are intended for short- or long-term use. The difference is usually in terms of the duration of treatment, which is either known right from the beginning (e.g. antibiotics), or determined by the disappearance of symptoms or successful healing (e.g. pain medication following a fracture).