ALLIED

QuantCare Patient Care

The real reason(s) why patients aren’t turning up

Patient treatment adherence is, and has always been, a key challenge in allied health. For example, up to 65% of patients with musculoskeletal health conditions are either non-adherent or partially adherent to their prescribed programmes. 

Sadly, there is no straightforward way to understand when and why a patient may drop-out during their treatment journey. This leaves clinicians frustrated and wondering…

  • Why isn’t my client sticking to their program when I know it’s good for them? 
  • Why is my client suddenly cancelling or not attending their appointments? 

So, how can we understand why a patient may disengage and therefore become “at-risk” of relapse?  

Practising patient-centred care

By practising patient-centred care, rather than treatment-driven or injury-driven care, we may gain deeper insight into why patients are not adhering to their treatment. Practising patient-centred care means using a biopsychological approach to understand treatment adherence

The biopsychosocial approach posits that social and psychological factors are equally important and in some cases more important than biological factors in predicting patient treatment adherence and recovery outcomes. This is particularly true for patients who either have chronic conditions or are at risk of developing chronic conditions (e.g.chronic pain). 

By consistently applying the biopsychosocial model of care in clinical practice, we are able to emulate patient-centred care. This means looking out for factors that may predict risk of treatment adherence. 

So, what should I be on the lookout for?  

A multitude of factors may put patients at-risk of treatment adherence – here are a few that may be applicable to patients with musculoskeletal injuries. 

1. High difficulty with daily activities

This includes the perceived level of difficulty patients have with key physical activities that they engage in on a regular basis (e.g., walking, sitting, running).

2. Low quality of life 

This includes satisfaction with quality of life as a whole, including different aspects of life such as, work, finances, and relationships. 

3. Poor overall experience at the clinic 

This may be informed by a combination of factors such as, in-house treatment experience, whether a patient felt cared for, whether a clear treatment plan was provided and how friendly the staff were. 

4. Low belief in treatment efficacy 

This captures the patient’s perception of whether the particular allied health discipline will improve their condition. Low initial belief in the efficacy of treatment tends to result in poorer treatment adherence and recovery outcomes. 

5. Duration of injury/condition 

Patients who have experienced their condition for long periods of time (and thus likely to have issues such as chronic pain) are more likely to have poor recovery outcomes attributed to social and psychological factors. 

Of course, this is a non-exhaustive list and there may be a variety of other factors based on your specific discipline and based on specific patient injury/condition. However, this is a starting point to help with putting holistic, patient-centred care into practice.  

But, how do I capture all this patient information? 

Knowing what information to look out for is powerful, but how do we actually capture this information in a time-poor clinical setting? Subjective assessment can take anywhere from 45-60 minutes upwards in an initial consultation. Even so, it is possible to miss key risk factors, particularly those that patients are reluctant to disclose face-to-face, such as psychological beliefs.  

Thus, we need to provide patients with the opportunity to disclose various aspects of their treatment journey, including information about themselves and also their experience with their healthcare providers, in a way that is secure, user-friendly and convenient. 

Leveraging digital health technologies to capture, analyse and interpret patient-reported outcome and experience measures (PROMs and PREMs) presents us with a way forward to practise value-based, patient-centred care. 

In this way, holistic, personalised care may result in greater treatment adherence, increased retention and most importantly, better recovery outcomes for patients. 

Indeed, it’s about time that we bring the patient voice into clinical practice.

About Dr. Rav Fernando

Dr. Rav is a psychological scientist with a PhD in social psychology from the University of Melbourne. Her research specialises in attitude and behaviour change and understanding the fundamental question – “why do people do what they do?”. 

Having experienced chronic pain and undergoing intensive treatment, Rav was inspired to use her research and data analysis skills to pick up “at-risk” patients early in the treatment journey. 

This resulted in QuantCare a platform to help healthcare providers use the power of data to practise patient-centred care and improve their business at the same time. Her mission is to bring the patient voice into clinical practice and help healthcare providers use data for good. 

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