Improving your Patient’s Compliance

To prevent life-threatening, chronic complications, your hypertensive patient must comply with his prescribed treatment plan. Unfortunately, many hypertensive patients don’t comply. If your patient isn’t following his treatment plan, identify the reasons and then take corrective action. Here are some common causes of noncompliance, along with proven intervention strategies.

Patient Isn’t Involved in Decision Making

Many times, the health care team makes the mistake of deciding what’s best for the patient and then telling him what to do. But patients who aren’t involved in the planning tend to not get involved in the plan. So be sure to include the patient in discussions about his treatment.

Encourage him to identify problems he might have in complying with the options under discussion. Remember, he’ll be more likely to comply with a treatment plan he feels he can realistically follow.

Patient Thinks his Blood Pressure is Normal

Patients who feel well may assume that their blood pressure isn’t a problem. Teach your patient how to measure his own blood pressure at home and advise him to record how he feels at the time he takes each measurement. Doing so will help him realize that regardless of how he feels, his blood pressure will begin to climb if he forgets to take his antihypertensive drug, cheats on his diet, or fails to reduce his stress.

Patient Doesn’t Integrate Treatment Into Everyday Life

The complexity of treatment is inversely related to the degree of patient compliance. This poses a major problem in managing hypertension because several treatments-lifestyle changes and drugs-are usually needed to maintain normal blood pressure.

Anything you can suggest to simplify your patient’s treatment plan may help foster compliance. For example, if your patient must take a drug several times a day, ask his physician to substitute one that requires less frequent dosing. Or if the patient must take several different drugs, ask the physician to prescribe a combination product to simplify the patient’s drug regimen.

Patient Can’t Afford Drugs and Foods

Many patients with limited incomes are embarrassed to reveal that they have difficulty purchasing the drugs and foods required for their treatment. To identify this problem early on, explore your patient’s ability to pay when you discuss the treatment plan with him. If you identify a problem, call the social worker to make alternative arrangements for your patient.