How can we accept that we should stop smoking, adhere to diet, exercise or take medication? The aim of this book is to describe the mechanisms of patient adherence to long-term therapies, which the World Health Organisation (WHO) believes would benefit more than any biomedical advances. For example, about half of patients do not adhere to medication regularly, which has a detrimental effect on people's health and a strong impact on health expenditure. This book describes how our beliefs, desires and emotions influence our choices about our health, referring to concepts developed within the philosophy of mind. In particular, it attempts to explain how we can choose between immediate pleasure and distant reward - preserving our health and life. We postulate that such an 'in-between' choice may be guided by a 'foresight principle' that leads us to prioritise the future. Like patients' non-adherence to prescribed medicines, doctors often do not always do what they should: fail to follow good practice guidelines. We suggest that what has recently been described as 'clinical inertia' may also be a case of myopia: from time to time, doctors fail to consider the long-term interests of their patients. Both patient non-compliance and clinical inertia on the part of doctors are major obstacles to effective care. However, it is also necessary to respect patient autonomy.
The Mental Mechanisms of Patient Adherence to Long-Term Therapies: Mind and Care
16 December 2022