An Apple a Day and Adherence to the Plan

​Over the last decade peer reviewed studies have established that patient compliance/adherence to plan (health care advice regarding diet, exercise, meds etc.) has been less than ideal. The percentages vary as much as 25-50% at best depending on the situation. They include such actions/inactions as; over/under dosing meds, making up for forgotten doses, stopping short of recommended term. This goes for exercise prescriptions as well i.e., +/- activity, +/- rest, altered frequency, making up for missed/lost doses etc.
 
It seems a no brainer that good advice in the interest of advocating better health at low to no cost wouldn’t meet resistance but it does. 

​Why?
    
These health journals observe too many categories to list here but it is interesting to note that those with the most severe illnesses tend to be least compliant. Mitigating factors of stress, depression, other bio-psycho-social issues often play a heavier diversionary role with these individuals.
    
Those with less severe life threatening illnesses seem to fare better with certain variables. An individuals health literacy is a compelling factor as well as the perceived sense of care and knowledge the health care provider makes available.
    
Some folks are touch hungry, starved for contact. Some are defined by their illness and fear loss of some recognized identity, their red flag waving as a marker for their place. Some are just ‘too busy’ or imply they are ‘too important’ else the world would stop, the company collapse..Remember that on pre-flight oxygen mask drill that adults with children are cautioned to don their mask first to better care for the children.
    
Education is invaluable to allow informed choice and is empowering to the patient in that it places the role of responsibility apportioned correctly.
One can not be forced to mend, heal, relax, straighten up and fly right against ones will or desire especially if consistency of related behaviors are key to recovery. Every health care provider has a responsibility to offer some kind of plan and its’ importance clearly. 
    
I often describe the math as 50% of what I do and 90% of what you do. While there may be some wiggle room it is hoped that your health care provider has your best interest in mind and the plan is part of the methodology to get well
    
When dosage, frequency and term are established with an understanding that any negotiation or lapse only diminishes a better outcome the road to recovery may get rocky, change course, morph into something unexpected.
    
Each stage of compliance is a window for that moment and while there may be other windows down the line they don’t offer the same view and opportunity. After all the brain, the chemistry, the tissues have missed a feeding and that potentially creates a different environment.
    
So, how do you get to Carnegie Hall....?