Understanding the challenge of patient non-adherence

Relative Insight’s platform was developed in the UK by using comparison technology to detect subtle linguistic differences used by adult men posing as children online. We now apply the same methods to uncover unexpected differences in the way people use words, and our technology enables customers and clients to get business value from language data.

By comparing different demographics or points in time, you can discover and then track trends that you haven’t thought of before. You’ll discover ‘unknown unknowns’ that will become the actionable insights crucial to shaping new strategy.

In the US, 66% of patients taking prescription medication are nonadherent. To understand more about why this huge number of people are not taking their medication, and to make recommendations on a comms strategy that would encourage them to take their medicine, we compared the discussion around nonadherence between healthcare practitioners (HCPs) and patients on forums.

Mental Capacity – ∞
Healthcare professionals are infinitely more likely than patients, to cite lack of mental capacity to follow advice or make decisions as a reason for nonadherence.

Example comment: “Her capacity to consent to levothyroxine is impaired by a mental disorder

Recommendation: HCPs should consider thinking about the mental capacity of their patients when designing treatment plans, incorporating steps to overcome potential barriers to adherence such as involving family members.

Advice – x2
HCPs are twice as likely to identify treatment instructions as ‘advice’ rather than ‘instructions’ and as such don’t always view nonadherence as a patient failure. There is an understanding between this peer group that their advice will not always be followed.

Example comment: “I doubt whether poor control among my patient population can be attributed to excessively close adherence to dietetic advice

Recommendation: HCPs should position treatment plans as instructions to be followed closely by their patients, not as advice or a suggestion.

Gap between theory and practice – x5.5
HCPs are more likely to discuss treatment in academic terms, and are five and a half times more likely to discuss gaps between medical trials and practice.

Example comment: “Recommendations to provide shorter prescriptions are not substantiated by the current evidence base

Recommendation: HCPs should focus on reducing complexity for their patients. Instructions need to be easily understood by patients and their families to increase chances of adherence.

Side-effects – x7
Patients are seven times more likely than healthcare professionals to cite side-effects – both physical and mental – as the reason for nonadherence.

Example comment: “I started having bad side-effects after the 13th tablet so I stopped

Recommendation: Potential side-effects should be clearly explained to patients and weighed against the benefits of taking medication.

Good attempts – x8.5
Patients are nearly nine times more likely to talk about ‘attempting’ to follow a treatment plan prescribed to them, before giving up for lack of results or overwhelming side effects.

Example comment: “I have just stopped taking champix after 3 weeks after starting to get very depressed

Recommendation: HCPs should clearly communicate expected timeframes for realising the benefits from the treatment plan to patients.

My body – x38.5
Patients attribute stopping treatment because they feel that their bodies are telling them to do so, and are 38.5x more likely than HCPs to mention their own body in relation to nonadherence.

I can barely get out of bed, and all day my body feels like I just ran a 26 mile marathon. All day, every day, my body feels physically ravaged

Recommendation: Patients should be fully educated about the impacts a drug is likely to have on their body. Support groups with other patients may also be beneficial.


Through consumer insight analysis, we can shed light on some of the common factors affecting adherence and help HCPs overcome these challenges to improve patient care.


  • HCPs should better manage expectations of patients when providing treatment plans. This includes discussing, not only the benefits but also the expected side-effects and time-frame for seeing results.
  • Engaging with family members can help overcome barriers to adherence, particularly for patients who may suffer from some mental incapacitation.
  • HCPs should leverage their expertise to provide clear, honest and assertive instructions for their patients, including the potential consequences of nonadherence. Treatment plans should be put forward as ‘instructions’ rather than ‘advice’.

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