Patient compliance is an obstacle in any medical practice. It can be especially problematic when topical medications and cosmeceuticals are prescribed because patients do not always realize how important topicals can be for skin health. Studies show that physicians can improve compliance by increasing the frequency and number of follow-up visits for your patients. This article provides an overview of the latest research and recommendations for improved compliance and outcomes.
Patient Communication, Education, and Engagement are Key to Compliance
Patients only remember about 3 to 5 things that you tell them during the consult. Information sheets can be very helpful to make sure that your patients understand their skin issues and treatment plan. During their visit, patients should receive a print-out with step-by-step instructions detailing their prescribed regimen (including cosmeceuticals) as well as the contact information for your office in case they have a question when they get home. We offer a WhatsApp text number for patients to ask questions. We also use the Skin Type Solutions App to educate our patients about their skin care regimen and what order to use the products and prescriptions.
Encourage Follow up Visits Within 2 to 4 Weeks after the First Visit
Patients usually lose motivation within four weeks of leaving the office, if not earlier. It is crucial that their next visit is scheduled before they leave your office, because this is when they are the most motivated to follow your advice. Patients will be much more likely to come for a follow-up appointment if they’ve already scheduled it while in your office. We contact our new patients within three days to check on them and see if they have any questions or concerns. We also take baseline Canfield photos and explain to the patient that we will compare the photos at the next visit. This way, they feel accountable and are more likely to follow instructions. Many patients look forward to seeing the follow up photos, so this can also help patient compliance and engagement. I always joke with my patients that I’m monitoring them and will be able to tell if they are using their products or not by looking at the photos.
Make Getting Prescriptions As Easy As Possible
Product Use Improves Before and After Appointments
Feldman’s team showed that patient compliance tends to increase during the days leading up to a doctor’s visit and in the following days. Thus, the longer amount of time in between visits, the less likely the patient is to be compliant. For this reason, I recommend scheduling follow-up visits at least every four weeks to check in with your patients and help to encourage compliance. You can have a system to text patients or an interactive app to keep patients engaged.
Frequent follow visits also give you a chance to assess any side effects and adjust the regimen accordingly. For example, patients who are starting a new retinoid regimen may need to use the product less frequently at first until their skin adjusts. If patients experience side effects like dryness and flaking, they may quit using the product until their next visit. It is a shame to waste four weeks of a patient’s time because they could not tolerate the retinoid. We encourage patients to communicate with us through an app to make sure they are using their medication properly and know how to adjust if they develop side effects.
Studies Show That Adding an Extra Visit Improves Compliance
Studies have shown that 95% of patients underuse their topical medications. According to a 2010 paper, average patient adherence to topical medications is only around 25% to 35%. However, Sangransky et al. found that by adding an extra visit between the initial appointment and the first four-week follow-up, patient compliance can be improved. In this study, atopic dermatitis patients were divided into two groups. The first group had follow-up appointments at weeks 1 and 4 following their initial visit. The second group only had a four-week follow-up. Adherence was electronically measured using Medication Event Monitoring Systems (MEMS) cap technology, which measures every time the medication container is opened.
Results showed that the group with the extra follow-up at week one had an average adherence rate of 69%, compared to the 54% average adherence rate of the group without the extra visit. While this was a small study with only 30 participants, its results point to an opportunity for further investigation and perhaps trials that doctors can perform themselves in their offices.
Improved patient compliance can have a profound effect on patient outcomes and referrals. Keep patients engaged and motivated to stick to their prescribed regimens by providing written instructions, emphasizing patient education with your staff, and increasing the frequency and number of scheduled follow-up visits.
I developed the Skin Type Solutions System to help improve patient compliance. The patient educational materials and the engaging app make it simple to help improve compliance. To learn more, visit www.STSFranchise.com.
Connect with me (Leslie Baumann) on LinkedIn to share your ideas about how physicians can improve compliance, and to read more news and articles that I post.
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