Challenges and Solutions to Patient Adherence

Non-Adherence or a Lack of Self-Care

Non-Adherence as a frequent cause of avoidable hospitalization

National implications

Reasons for non-adherence

• Patient related
• Clinician related
• Health system related

Multiple co-morbidities and adherence

• Barriers to self-care
• Low literacy and cognitive impairment
• The older adult
• Break in Continuity of Care

Strategies to Enhance Adherence or Self-Care Management

Disease management (health management) to enhance self-management

• Key components

Self-care management

Patient-centered care

Increase access and continuity of care

Improving transitional care

Behavioral strategies

Motivational interviewing

Simplifying the complex

How to educate patients

• Teach back Methods

Increasing communication and collaboration on an interdisciplinary team

Handling relapses

Supporting NPSG and IOM competencies and health care reform

Disease Management Strategies for the most Common Co-morbidities (Heart Failure, Diabetes Mellitus and COPD)

Enhancing patient self-care management by improving our knowledge of these illnesses and applying this knowledge to any patient situation

• HF, Diabetes, and COPD made simple
• Evidence-Based guidelines
• Lab recommendations
• Non-Pharmacological interventions
• Simplifying a low sodium diet, and a carbohydrate consistent meal plan
• Teaching daily weight monitoring
• Teaching effective self-monitoring of blood glucose and insulin administration
• Teaching effective use of inhalers, nebulizers, and oxygen
• Simplifying the complex pharmacological management of these illnesses
• Device therapy
• Handling hypoglycemia, hyperglycemia, and sick days
• Self-Care plan and recommended screening
• Complications of chronic disease
• Preventing exacerbations Important teaching points for HF, Diabetes, and COPD
• Promoting weight loss/Exercise
• Promoting tobacco cessation

Other skills and options to enhance self-care management

How to perform a comprehensive assessment and not miss anything

Telehealth as a disease management strategy

• Store and forward vs. audio & video interaction
• Implications for telehealth

Applying immediate changes in patient care to enhance self-management

The Dos and Don’ts of documentation

Patient self-care management from hospital to community

Patient tools

Clinician tools

Interactive case studies