Clinical Scorecard: Utilizing Staff for Patient Adherence

At a Glance

Key Highlights

• 40-60% of patients cannot correctly recall provider instructions within minutes; over 60% misunderstand immediately after consultation.
• Allied health staff can improve adherence by reinforcing education, summarizing instructions, and acting as patient advocates.
• Addressing barriers such as dexterity issues, asymptomatic conditions, cost, routine disruption, and side effects improves adherence.

Guideline-Based Recommendations

Diagnosis

• Identify patients at higher risk of nonadherence through assessment of understanding and physical limitations.

Management

• Allied staff should summarize provider instructions and use teach-back methods by asking patients to repeat key steps.
• Designate staff as patient advocates to provide follow-up calls for encouragement and question resolution.
• Create clear instruction sheets illustrating medication timing and usage.
• Provide methods to accommodate dexterity or vision impairments, including involving family or friends.
• Re-emphasize education for asymptomatic patients to motivate adherence.
• Inform patients about savings programs, rebates, payment plans, and financing options to reduce cost barriers.
• Align treatment regimens with patients’ daily routines to reduce disruption.
• Offer tips to manage side effects and communicate these to providers for possible treatment adjustments.

Monitoring & Follow-up

• Periodic check-in calls by designated staff to assess adherence and address patient concerns.

Risks

• Nonadherence can lead to delayed or negative outcomes, increased healthcare visits, patient frustration, and higher costs.

Patient & Prescribing Data

Patients with ocular conditions requiring complex or multi-level treatments

Complex regimens and multiple medications increase adherence challenges; tailored education and support improve compliance.

Clinical Best Practices

• Educate allied health staff on common reasons for nonadherence and strategies to overcome them.
• Use teach-back questions: 'Do you have any questions about what the doctor said?' and 'Can you tell me the steps you need to take at home?'
• Encourage involvement of family or friends for patients with physical limitations.
• Provide written and digital resources to reinforce verbal instructions.
• Proactively address cost concerns by informing patients about available financial assistance.
• Tie medication schedules to daily habits to improve routine adherence.
• Offer practical tips to mitigate side effects, such as refrigerating drops or using lubricants before instillation.

References

• Jimmy B, Jose J. Patient medication adherence: measures in daily practice. Oman Med J. 2011
• Zaharia AC et al. Adherence to Therapy in Glaucoma Treatment-A Review. J Pers Med. 2022
• Uchino M et al. Adherence to Eye Drops Usage in Dry Eye Patients. J Clin Med. 2022
• Keenum Z et al. Patients’ Adherence to Recommended Follow-up Eye Care After Diabetic Retinopathy Screening. JAMA Ophthalmol. 2016