Viewpoint: Brigham and Women’s physician says being a ‘nonadherent’ patient made her a better provider

Jessica Stuart, MD, a resident physician of internal medicine at Brigham and Women’s Hospital  in Boston, wrote in an opinion piece published Nov. 6 by STAT that her own experience as a “nonadherent” patient has helped her become a better and more compassionate physician.

Patients who don’t take their medications as prescribed are referred to as nonadherent. The issue of medication nonadherence has garnered a lot of attention in the medical community in recent years, Dr. Stuart wrote, as it is a major cause of adverse medical outcomes. Up to half of U.S. patients take their medications incorrectly or not at all. 

Patients’ reasoning for not taking their medications are numerous and often hard to understand for physicians, according to Dr. Stuart. Some include cost, lack of health literacy and denial. Dr. Stuart wrote about a patient she treated who successfully went through a liver transplant to later be hospitalized and almost die because he wasn’t taking his antirejection medications. 

When Dr. Stuart was 13 years old, she had non-Hodgkin lymphoma and had to take 11 pills per day, she wrote. Some of those pills were to fight the cancer, others to prevent side effects of the cancer drugs. 

At one point, she decided to stop taking the preventive drugs and only took the cancer drugs. While she can’t remember exactly why she made the decision, she said after reflecting on the choice, it was her way of “asserting control in a world that was spiraling out of control.” 

“I did not want or choose to be sick, so I decided I would not adhere to the medical regimen that had been imposed on me,” she wrote. 

Her nonadherence lasted only a short while, and she eventually went into remission and has been lymphoma-free for 13 years. Due to her experience, she wrote that she has learned to approach nonadherent patients with “humility and compassion.” 

“I don’t pretend to have the answers to solve the epidemic of nonadherence. If anything, I tell my story to highlight the distinct psychological challenges of the ill and the way in which it is so hard for healthy people — my current self included — to understand them,” she wrote. 

Read the full article here

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