If you are frequently frustrated by patients who don’t stick with prescribed treatments, you’re not alone. Two important strategies for managing chronic disease are adherence to treatment and sustained, health-related lifestyle changes; however, research suggests that approximately 50% of patients with chronic conditions do not adhere to treatment, including dietary changes, physical activity, blood monitoring, and medications.1
Learn more about Applying Functional Medicine in Clinical Practice (AFMCP) – a different kind of medical conference, where practitioners learn proven techniques for helping patients follow treatment plans >
A meta-analysis of compliance for patients with diabetes, hypertension, and dyslipidemia showed that only 59% take more than 80% of the prescribed doses of medication in a year.2 Another study has shown that even in the instance of serious and symptomatic disorders like acute myocardial infarction, as many as one in eight patients discontinue all three medications of the commonly prescribed combination of B-blocker plus aspirin plus statin within one month of hospital discharge. Without taking all three classes of medication, these patients have an 80% greater chance of dying within the first year after hospital discharge.2
In a case discussion published in JAMA, Thomas Bodenheimer, MD, wrote: “A participatory relationship between patient and physician appears to be the most important factor promoting medication adherence” and that “the more actively the patient is involved, the higher the level of adherence and the greater the chance that the patient engages in healthy diet and exercise behaviors.”3
Recent studies suggest that establishing and maintaining a strong, empathic relationship with the patient may be the most crucial factor for his or her success in the long-term with lifestyle changes such as weight loss, tobacco cessation, and increased activity level.4,5 A 2009 study of overweight, insulin-resistant individuals found that while weight loss and improved cardiovascular risk factors improved during a four-month intervention, more frequent monitoring for an indefinite period of time was necessary for nearly two-thirds of patients to maintain their lifestyle changes long-term.6
The Functional Medicine model was developed, in part, to educate practitioners in ways to bolster patient compliance. Functional Medicine is grounded in a strong patient/provider relationship. Specific tools—like the IFM Timeline and Matrix—help the practitioner understand the course of the patient’s life as seen through the lens of health and disease. Often, disease occurs when fundamental lifestyle factors like diet, movement, rest, and/or sleep are lacking or imbalanced in an individual’s life.
However, patients with chronic conditions may already be overwhelmed by burdensome illnesses and treatments and have a difficult time incorporating behavioral modifications into their daily routine.7 IFM offers a range of tools—like the IFM Food Plan and Elimination Diet—to guide the practitioner in designing a personalized treatment plan that helps the patient achieve an optimal outcome.
Integrating the simple strategies of modifiable lifestyle factors in a healthcare plan will improve patient responsibility and increase overall health and well-being. In the following video, attendees of IFM’s foundational course, Applying Functional Medicine in Clinical Practice (AFMCP), explain how the conference provides the basis for understanding patient motivations and compliance:
AFMCP is a different kind of medical conference, where practitioners learn proven techniques for helping patients follow treatment plans. Using case-based, interactive presentations, expert educators engage attendees in real-world situations and demonstrate proper use of a suite of clinical tools that help improve patient compliance and patient outcomes.
- Lindner H, Menzies D, Kelly J, Taylor S, Shearer M. Coaching for behavior change in chronic disease: a review of the literature and the implications for coaching as a self-management intervention. Aust J Prim Health. 2003;9(3):177-185. doi:10.1071/PY03044.
- Kleinsinger F. Working with the noncompliant patient. Perm J. 2010;14(1):54-60.
- Bodenheimer T. A 63-year-old man with multiple cardiovascular risk factors and poor adherence to treatment plans. JAMA. 2007;298(17):2048-2055. doi:1001/jama.298.16.jrr70000.
- Brandt CJ, Søgaard GI, Clemensen J, Søndergaard J, Nielsen JB. Determinants of successful eHealth coaching for consumer lifestyle changes: qualitative interview study among health care professionals. J Med Internet Res. 2018;20(7):e237. doi:10.2196/jmir.9791.
- Brandt CJ, Clemensen J, Nielsen JB, Søndergaard J. Drivers for successful long-term lifestyle change, the role of e-health: a qualitative interview study. BMJ Open. 2018;8(3):e017466. doi:10.1136/bmjopen-2017-017466.
- Dale KS, Mann JI, McAuley KA, Williams SM, Farmer VL. Sustainability of lifestyle changes following an intensive lifestyle intervention in insulin resistant adults: follow-up at 2-years. Asia Pac J Clin Nutr. 2009;18(1):114-120.
- Bodde AE, Shippee ND, May CR, et al. Examining health promotion interventions for patients with chronic conditions using a novel patient-centered complexity model: protocol for a systematic review and meta-analysis. Syst Rev. 2013;2:29. doi:10.1186/2046-4053-2-29.