According to a study, researchers examine physicians can create an adherence protocol for patients, particularly children and teens, receiving treatment for atopic dermatitis. The study was published in Dermatology.


Lack of adherence to treatment protocols can arise for many reasons, including a lack of motivation or laziness, giving up after trying the treatment (e.g., thinking the treatment is worse or more burdensome than the condition), forgetting instructions, or just forgetting to take the medication.


Overall, if patients aren’t implementing your guidance, he says, it’s likely for one of these reasons:

1. Lack of motivation 
2. Seeking some other gain
3. Distrustful of you
4. Scared of the medicine or treatment
5. Forgot your instructions
6. Treatment is more burdensome than the disease
7. Treatment is believed to be worse than the disease
8. Forgot to use the medicine
9. Lazy or couldn’t be bothered

Create An Adherence Protocol

It’s possible to improve how well your patients follow your instructions, though. Feldman recommends establishing a system to encourage adherence from the first visit.

Schedule follow-ups:

Patients are more likely to fill prescriptions and use medications if they know they’ll see you again soon. In fact, Feldman cited a study showing a 1-week return visit was more effective in prompting kids to apply 0.1% tacrolimus ointment than a parent or electronic reminders.

Simplify treatment:

Make the protocol as easy to follow as possible. If it requires too many steps, patients are less likely to do it. Don’t rely on patients’ memories. Give them written instructions that include an explanation of their condition, treatment tips, guidance for managing flare-ups, and details on when to call you.

Create Triggers:

Calendar and digital reminders can be effective tools in facilitating patient compliance. Additionally, “barrier” triggers, such as putting anti-fungal creams on top of a sock drawer, or special packages, such as weekly pill boxes, can also be helpful.

Create motivation:

Provide positive feedback, such as sticker charts for young children.

Employ teen psychology:

Don’t acknowledge teen non-compliance. Instead, talk about medications teens use frequently or about reminder systems that work well for the age group.

Offer anecdotes:

Share success stories to help them feel comfortable with treatment. Concentrating on patient adherence might not be your primary focus, Feldman says, but with the right compliance protocol, you could be as effective in helping patients stick with treatment as you are providing a diagnosis.

He suggests a system to encourage adherence that includes scheduling follow-ups, simplifying treatment, writing a plan, creating "triggers" such as a calendar or digital reminders, providing positive feedback, and sharing success stories.

Concentrating on patient adherence might not be your primary focus," Feldman said in the article, "but with the right compliance protocol, you could be as effective in helping patients stick with treatment as you are providing a diagnosis.