Every year, millions of people resolve to adopt a better diet, exercise more or lose weight, but doctors know that the likelihood of patients developing new health behaviours and maintaining them is low. In fact, studies show that between 25 and 50 per cent of patients do not follow doctors' recommendations. Noting that doctors receive little training in medical schools on how to change patients' behaviour, a national team of research psychologists has published a book outlining effective strategies for healthcare professionals to help patients improve their health behaviour and adhere to treatment. The book " Health Behavior Change and Treatment Adherence: Evidence-Based Guidelines for Improving Healthcare". (Oxford University Press 2009), is co-author with Kelly B. Haskard-Zolnierek, assistant professor of psychology at Texas State University-San Marcos; M. Robin DiMatteo, distinguished professor of psychology at the University of California, Riverside; and Leslie R. Martin, professor of psychology at La Sierra University, Riverside, California.
Drawing on 50 years of empirical research, the authors show that three components must be present before a patient's behaviour can be changed: 1) The patient must understand what type of change is expected; 2) The patient must be motivated to perform the behaviour; and 3) The patient must have the tools needed to change the behaviour. Factors such as access to medical care and insurance certainly affect a patient's ability to adhere to treatment, Haskard-Zolnierek explained, but the quality of communication between doctor and patient is a key determinant of a patient's understanding of the treatment and their motivation to adhere to it.
"If, for example, patients are dissatisfied with the doctor's form of communication, they are less likely to continue treatment," said Haskard-Zolnierek. "On the other hand, when doctors communicate affectively - when they are friendly and empathetic and when they give clear information without using medical jargon - patients are more satisfied with their treatment and adhere to it." Recognising that busy healthcare professionals work to tight schedules, the authors provide simple strategies to
helping patients understand what they need to do, convincing them to change their behaviour and overcoming barriers to change. For example, healthcare professionals can:
- Use a team approach to providing patient care, providing pre-visit advice to the patient and assisting in setting up the healthcare programme
- Provide interactive decision aids to help patients get the information they need to make medical choices
- Provide group visits for patients with the same chronic disease
- Provide technology-based aids to facilitate compliance, such as reminders via mobile phone or email
Drawing on thousands of empirical studies, the authors also offer guidance on topics such as improving health through habit formation and management, helping patients with risk assessment and decision-making, working effectively with patients, and creating partnerships between patients and the healthcare system.