Medical residents: What to do when patients won’t take their meds

Millions of patients take their medications improperly or not at all, and this nonadherence takes a toll on society and the health care system. 

Every year in the U.S., there are about 125,000 deaths that could have been prevented if patients had been taking their medications correctly, according to data presented in a 19-minute module from the AMA. The course examines the problems of medication nonadherence and offers strategies to help medical residents better communicate with their patients and help them manage their medications.

This medication nonadherence annually leads to between $100 and $300 billion in avoidable health care costs, says the module, "Promoting Medication Adherence," which is one of the AMA GME Competency Education Program offerings, which include nearly 30 courses that residents can access online through their institution’s subscription, on their own schedule.

Among the program’s experts are several who contributed to the AMA’s Health Systems Science textbook, which draws insights from faculty at medical schools that are part of the Association’s Accelerating Change in Medical Education consortium.

Modules cover five of the six topics—patient care, practice-based learning and improvement, interpersonal and communication skills, professionalism, and system-based practice—within the Accreditation Council for Graduate Medical Education’s core competency requirements. The sixth requirement, medical knowledge, is one that is typically addressed during clinical education.

The module is designed to help residents identify factors that lead to nonadherence, and outline strategies to help patients follow their prescribed regimen.

The module clearly distinguishes between intentional and unintentional medication nonadherence, and highlights the need for residents to identify why patients stop taking their medication as prescribed. Recognizing whether a patient didn't follow instructions because of concerns about side effects or instead stopped because symptoms were no longer present will go a long way in determining how to best encourage medication adherence.

Once residents recognize what is causing a patient not to follow the prescribed regimen, the next step is determining how best to talk through possible solutions. The module reviews various communication strategies and tips for residents to consider when approaching a discussion around adherence with a patient. For example, from avoiding jargon to using visuals, it is important to present information simply without overwhelming the patient.

Patients who are committed and confident in their treatment plan are more likely to adhere, so once explanations for the treatment have been provided, it is up to the resident to confirm the patient understands and is devoted to the plan.

There are several indicators that can help residents improve adherence, and the module reviews those as well as ways to personalize their approach to effectively partnering with patients. Residents should feel empowered to ask questions and not assume patients understand or feel comfortable with the treatment plan.

Visit the AMA GME Competency Education Program for more information on this and other offerings or to request a demo.