Nonadherent Patients: Factors to Consider Before Discharge
Healthcare providers have the right to choose which patients they want to treat. They also have the right to terminate relationships with patients for various reasons, as long as they are not violating state or federal laws (e.g., in relation to discrimination or abandonment).
Patients who are nonadherent with their treatment regimens or follow-up care recommendations can be particularly frustrating, and they also might be more likely to have suboptimal outcomes as a result of their behavior. For these reasons, healthcare providers might feel discharging the patients from the practice is the best solution. However, when determining how to manage patient nonadherence, providers should consider both subjective and objective information about the patient’s behaviors and activities.
Although some patients may simply refuse to take their prescribed medications or may frequently cancel or skip appointments due to poor schedule management, other patients might have educational, emotional, financial, or physical limitations that contribute to their nonadherence. For example, patients who have cognitive impairments might struggle to follow instructions regarding their treatments. Patients who have financial issues might cut corners because they cannot afford their medications, or they might cancel appointments because they don’t have transportation.
In other cases, a simple lack of awareness might play a role in patient nonadherence. For example, patients might stop taking their medications if they no longer have symptoms. Because they feel better, they may not realize the importance of continuing the treatment. Educating patients about their conditions and the need to follow through with treatment plans could resolve these issues of nonadherence.
Thorough review of each situation — as well as consideration of patients’ limitations — might lead to a solution to the problem without severing ties. Effective provider–patient communication and a well-trained staff can help identify, address, and possibly resolve some causes of nonadherence as well as help ensure that patients receive appropriate care.
For more information about managing patients who have difficulty following their treatment recommendations and care plans, see the following MedPro resources: Guideline: Managing Nonadherent Patients, Guideline: Patient Agreements in Clinical Practice, and Risk Tips: Managing Nonadherent and Difficult Patients.
