“It’s YOUR job to fix me!”

stressed nurse

When your patient’s don’t follow your medication instructions…and then are upset “it didn’t work”
 
We’ve all had patients who struggle to follow our medication recommendations (and some patients who then blame us that the medications aren’t working!).
 

Maybe they only took your prescribed medication for a few days then stopped when they weren’t feeling better. 

Or they didn’t even pick up the medication from the pharmacy because they didn’t think it would help. 

This patient then returns to your office complaining that treatment isn’t working. 

Insert subconscious eye roll and sigh. 

We’ve all been there with patients. 

While frustrating, there are SO many reasons why our patients don’t always follow our medication recommendations. 

One systematic review study found 8 different factors that influence whether our patients will take the medications we prescribe.

Some of these factors include: perceived lack of benefit from the medications, side effects, cost of the medication, dosing frequency, routes of administration, patient beliefs, demographics and comorbidities. 

 

So, what do we do about this frustration?
 
✅ COLLABORATE with you patient on a plan of care, don’t just tell the patient what the plan of care is. 

I’ve heard from many patients over the years that they have had difficulty with previous providers who “don’t listen to me” or “don’t explain anything”. It’s important to really take a collaborative approach when providing care. Lay out treatment options, explaining pros and cons, and then ask the patient about their thoughts. 

This doesn’t have to be a long, drawn out conversation. Taking 3 to 5 minutes makes the difference between being in sync and on the same page versus patients not following the recommendations and getting frustrated with lack of improvement. 

 

✅ Provide education on the medication and empower your patient to understand the treatment regimen and its benefits. 

We need to make sure we’re understanding patient preferences, answering questions, and providing clear explanations of why the medications we are prescribing should be taken. Ask clarifying questions and make your patients feel empowered to be self-advocates in their own health. 

I like to ask my patients, “what do you think will get in the way of following through?”. It’s a great way to understand patients’ perceived barriers and address them proactively.

 

✅ Reduce barriers to obtaining medication, including cost reduction (such as GoodRx). 

Cost is a huge potential barrier to following through with treatment recommendations. This can be a total pain because as busy providers, its not like we have all the free time in the world. 

BUT, what good is it if you assess a patient, come up with a collaborative treatment plan, order the medication, and then, because the patient can’t get the medication, doesn’t take it?….

Follow through from start to finish including making sure a patient can pay for medications or treatment is critical. 

 

 

Lack of medication adherence is going to be an ongoing issue you might struggle with in practice. Not all patients will follow recommendations. 

But, it’s important to know there are MANY reasons why a patient might not be compliant and that there are several ways to help improve medication adherence. 

It’s easy to blame the patient and move on but the most important take away is that more collaboration during visits results in healthier, more satisfied patients.

And less frustration (and exasperated sighs) on our parts.

Keep this in mind when you’re providing patient care and you’ll see more follow through and improved patient outcomes

 

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Your reference for creating clear, high quality notes (for Psych NPs!)

psychiatric evaluation template bundle contents