Simplify Treatments

Enhancing Patients’ Treatment Adherence

One of the “no brainer” ways to make adherence worse is to give patients a complicated treatment regimen to use. Many times, there may be a tendency to want to add more and more treatments in the face of resistant disease; when disease is resistant to treatment because of poor adherence (as it often is), this tendency is not likely to be productive. The low hanging fruit to improve adherence and our patients’ treatment outcomes is to simplify the treatment. 

Sometimes the pathogenesis of disease calls for using multiple treatments to target different components of the pathogenic process.  That’s all well and good if patients will take multiple medications reliably.  But it is hard to get patients to take even one medication reliably.  In my own research studies, I’ve found that not only does giving patients multiple medications at once reduce adherence over time, giving prescriptions for multiple drugs makes it more likely for the patient not to even fill the prescriptions.

Combination products may be one helpful solution to simplifying treatment when multiple medications are required.  Improving adherence to the first drug may be another helpful approach before prescribing a second, third or fourth product.

—Dr. Steven Feldman is a professor of dermatology and public health sciences at Wake Forest Baptist Medical Center in Winston-Salem, NC, where he studies patients’ adherence to treatment. He is also Chief Science Officer of Causa Reseach, an adherence solutions company, founder of and author of “Compartments”.