Practical Ways to Improve Patient Adherence

by Daniel J Lewis, Steven R Feldman

Overview

The New York Times has called adherence the world’s "other drug problem." Physicians prescribe medications, but patients do not always use them. While it would be easy for physicians to blame patients for treatment failures, physicians can do more to motivate patients to use their medications as recommended.

Practical Ways to Improve Patient Adherence, Second Edition, is an excellent resource for physicians and allied health professionals whose patients exhibit poor adherence. Daniel J. Lewis, MD (Department of Dermatology, University of Pennsylvania Health System), and experienced adherence researcher, Steven R. Feldman, MD, PhD (Departments of Dermatology and Social Sciences & Health Policy, Wake Forest University School of Medicine), examine the problem of poor adherence and offer concrete techniques to encourage patients to use their medications and improve treatment outcomes.

This book offers novel, potent ways to get patients to use their medications and improve treatment outcomes – tools healthcare providers can use day in and day out. A medical education is not complete without a thorough understanding of the hurdles that contribute to poor adherence and what health professionals can and should do about it.

"20 years of patient adherence research presented in a simple, fun, and easy-to-read style … a once-in-a-lifetime treat!"

Warren H. Chan, MD, MS, Dermatologist"East to digest and remarkably practical for physicians. … Recommend it to all my friends in medicine!"

Diego R. Dasilva, MD, Dermatologist

Named the winner of the 2022 “Best Overall” Dermie Award by the Dermasphere podcast.

Published in association with the Journal of Dermatological Treatment.

Product Details

ISBN-13:	9781032435022
Publisher:	CRC Press
Publication date:	08/18/2023
Series:	Series in Dermatological Treatment
Edition description:	2nd ed.
Pages:	140
Product dimensions:	6.00(w) x 9.00(h) x 0.00(d)

About the Author

Daniel J. Lewis, M.D. is a dermatology chief resident physician in the cutaneous oncology track at the Perelman School of Medicine at the University of Pennsylvania. Dr. Lewis earned a B.A. in Biology from the University of Pennsylvania, earned his M.D. at Baylor College of Medicine, and completed his internship at Memorial Sloan Kettering Cancer Center. He is a member of the Alpha Omega Alpha Honor Medical Society. He has authored over 75 peer-reviewed manuscripts as well as multiple textbook chapters. He was named Post-Doctoral Trainee of the Year in 2022 by ADEN and winner of the 2022 ASDS Young Investigators Writing Competition. He will be the 2023-2024 Micrographic Surgery and Dermatologic Oncology Fellow at the University of Pennsylvania.

Dan also works as a professional sports journalist and has written over 90 articles for Yahoo! Sports, Bleacher Report, and SB Nation (www.DanielLewisSports.com). Dan is also Founder of Penn Fitness for Life, a community service organization based in Philadelphia that seeks to combat the growing obesity epidemic in the United States by empowering children to live healthy lives.

Steven R. Feldman, M.D., Ph.D. is Professor of Dermatology, Pathology, and Social Sciences & Health Policy and Director of the Center for Dermatology Research at the Wake Forest University School of Medicine in Winston-Salem, North Carolina. He has authored over 1,200 peer-reviewed articles, and he has served as the principal investigator of industry, foundation, and federally funded studies.

Dr. Feldman has been ranked by ExpertScape as one of the top-five worldwide experts in psoriasis, dermatology, and treatment adherence. He has served as a member of the medical board of the National Psoriasis Foundation, chaired that board’s subcommittee on education, and served as Director of the Foundation’s Chief Residents’ Meeting on psoriasis treatment. He has also chaired the American Academy of Dermatology’s Psoriasis Education Initiative Workgroup. He was the founder of www.DrScore.com and Chief Science Officer of Causa Research. He is Senior Advisor, Dermatology & Patient Adherence, for Sensal Health. He serves as the editor of or an editorial board member for multiple dermatology journals and is the author of Compartments: How the Brightest, Best Trained, and Most Caring People Can Make Judgments That Are Completely and Utterly Wrong. He is also the creator of www.PromisedLandMuseum.org, The Jewish Museum of the Palestinian Experience.

Table of Contents

Chapter 1: Introduction
Section 1: The Problem of Poor Patient Adherence
Chapter 2: How Poor is Patient Adherence? Chapter 3: Qualitative Measures of Adherence. Chapter 4: Clinical Studies on Adherence. Chapter 5: Why Is Adherence So Poor? It is Our Fault. Chapter 6: A Pyramid Model for Improving Adherence.
Section 2: Foundation – Trust and Accountability
Chapter 7: Establishing the Physician-Patient Relationship. Chapter 8: Setting the Right Office Visit Context. Chapter 9: Fostering Patient Accountability.
Section 3: Practicality – Simplicity and Education
Chapter 10: Involving Patients in the Choice of Treatment. Chapter 11: Reducing the Burden of Treatment. Chapter 12: Educating and Providing Instructions. Chapter 13: Helping Patients Remember.
Section 4: Psychology – Behavioral Techniques
Chapter 14: Anchoring. Chapter 15: Giving Salient Descriptions. Chapter 16: Emphasizing Losses Versus Gains. Chapter 17: Framing Risks of Side Effects. Chapter 18: Using Side Effects to Our Advantage .
Section 5: Special Considerations
Chapter 19: Patients with Psychiatric Conditions. Chapter 20: Pediatric Patients. Chapter 21: Suddenly Adherent Patients. Chapter 22: The Most Adherence-Resistant Patients
Section 6: Sample Cases
Chapter 23: Pediatric Atopic Dermatitis. Chapter 24: Skin Cap for Psoriasis. Chapter 25: Coral Reef Psoriasis. Chapter 26: Scalp Psoriasis.
Section 7: Final Thoughts
Chapter 27: Poor Adherence Is Not All Bad. Chapter 28: Conclusions.
References

Editorial Reviews

Reviewer: Patricia Wong, MD (Private Practice)
Description: This book discusses engendering goodwill to make patients amenable to treatments that will improve their skin and trust in their dermatologists. Providers have often encountered the situation where they have the perfect approach to treating a given skin concern only to be stymied by patients' refusals to agree to the plan. The reasons can be varied. Patients can be fearful of the potential risks that may occur with medication, complying with the prescribed regimen seems like "too much work", patients feel there is a stigma associated with being on medication, or they know someone who took something similar and had a negative outcome. Effectively addressing these concerns and convincing patients to adhere to recommendations depends on the presentation style of this information.
Purpose: The purpose of the book is to explore effective pathways of communicating with patients in a way that fosters trust, conveys understanding and compassion, and gets positive results (patients follow the prescribed treatment and improve).
Audience: The audience is dermatologists that care for patients.
Features: The book suggests useful phrases that demonstrate caring and make patients feel that providers are on their side and trying to help them. It outlines practical suggestions for improving or creating commitment to a skin plan and gives tips on how to make powerful statements to create awareness and compliance. For example, comparing biologic injections to diabetics' self-administration removes the perceived alarm and danger associated with self-injections when compared to a scenario that patients are familiar with and accept.
Assessment: While many books published address "the difficult patient", this book argues that it is not patients who are difficult, but providers that must overcome inabilities or deficits in explaining disease and treatment in a way that engages patients rather than making them run away. Providers should not have to drag patients back into the office "to help them". I enjoyed the suggestions and plan to implement some of the phrases.

Doody's Review Service