Strategies to Improve Therapeutic Compliance in General Medicine

Abstract

Within the framework where overlap therapeutic alliance, patient-centred consultation and shared decision-making, the strategies to increase compliance during the consultation in general medicine are inserted. A strategy is, in a strict sense, an organized, formalized and oriented procedure to obtain a clearly established goal. Its application in daily practice requires the improvement of procedures and techniques whose detailed choice and design are the responsibility of the doctor. To achieve the goal of improving compliance in general medicine, within this model of patient-centred medicine / therapeutic alliance / shared decisions, a number of strategies can be cited: 1) Establish rapport and continuity of care that allows building trust; 2) Ensure confidentiality; 3) Sensitive exploration of adverse drug reactions and prevention of their effects on compliance; 4) Simplify the therapeutic regimen; 5) Self-monitoring; 6) Avoid giving the impression that the drug replaces the need for changes in habits (such as diet, exercise and smoking cessation); 7) Know the patient's agenda, explore perceptions of the disease, and assess the importance that the patient attaches to compliance, and their confidence in achieving it; this also includes understand and tolerate that the chronic patient sometimes gets tired and abandons the treatment that is necessary; 8) Involve the patient in the decision; and, 9) Motivational Interviewing and negotiation of therapeutic objectives, although they seem minimal from doctor point of view. Finally, it must be remembered that the patient always has the last word to accept our indications or not.