Monday, December 14, 2020

A Doctor's Personal Story on Being a Non-Adherent Patient.

Environmental & Science Education, STEM, Health, Medicine

Ed Hessler

The aim of this post is to link you to a post, one that has the sense of a diary entry, by a doctor who when she was a kid was a "non-adherent patient."

These are patients who both trouble physicians with a form of behavior that just doesn't seem reasonable. What they do is not in their best self-interest which is usually considered to be motivating.

First what is a non-adherent patient? Not too long ago the term was non-compliant. It refers to patients who refuse to take prescribed medicines. And about the replacement of the term non-compliant with non-adherent patient the reasoning is explained by the author, Dr. Jessica Stuart.

"Over the past several years, there has been a purposeful shift in language away from the term “noncompliant” toward the term “nonadherent.” Merriam-Webster defines comply as "to conform, submit, or adapt" whereas to adhere is "to give support or maintain loyalty.e Compliance connotes passive subservience while adherence means actively giving support to something. In this way, proponents argue, nonadherent invokes a greater degree of agency among patients."

Dr. Stuart describes her experience when she was 13 years-old, diagnosed with non-Hodgkins lymphoma. She took 11 medicatons daily and this led to a cascade of other effects, each to be lessened or prevented by other meds in that chain.  She stopped.

Stuart discusses her reasons as well as decision to take only certain ones--the chemotherapeutics. She describes herself as a Type-A person, driven to succeed so this is not what you might expect from such a patient. She examines as best she can recall her motivations and possibilities. This act of defiance didn't last long. She was discovered and she and her Dad had a "sit-down." She got back on her meds and recovered, lymphoma free now for 13 years.

And with that lesson she notes these are her plans for working with similar patients. "I do know that during my training in internal medicine and beyond I plan to approach 'nonadherent' patients with humility and compassion. I feel sad when I think back to the liver transplant patient and how the judgment-laden thought, 'How could he not take these lifesaving medications?' crept into my mind, knowing the same question could have been asked of me as a cancer patient. I’ll do my best to turn that exasperation into empathy and transform the question into a statement for nonadherent patients: 'Being sick is really hard.'”

We'd all agree with that last statement.

Here is the essay.


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