This Princeton University study was carefully done, tracking 1.2 million hypertensive patients over time and analyzing the data from different statistical perspectives. The reduction in monitoring frequency was from every month to every three months. The benefits might not be the same if the doctor visits are only yearly, let’s say. In addition, those patients participating in the program had already demonstrated stable control of their hypertension. The point remains, though, that overly intensive supervision by healthcare professionals could interfere with valuable patient self-management.
One explanation for what happened is that the patients appreciated not having to travel to appointments, pass time in the waiting room, and fill prescriptions as often. They were thereby motivated to comply with healthcare recommendations because this would qualify them to continue in the reduced-frequency program. That explanation is supported by how those patients who showed the benefits most clearly were those receiving their medical care from the most congested clinics. A related explanation is that people become more likely to follow healthcare instructions when it’s less difficult to do so. Additional lessons, then, are to reward people for good self-management, including self-monitoring, and to simplify adherence. This empowers healthcare consumers.
Other forms of empowerment might not work as well. Researchers at Erasmus University and University of Navarra analyzed programs where patients are provided information about options and then encouraged to make medical decisions for themselves. Arguments put forth for doing this type of informed consent are that it supports ethical patient interactions, relieves providers of blame for flawed outcomes, and increases compliance with the expert’s advice.
However, the study conclusion was that the amount of information necessary for true informed consent often disrupts proper adherence to expert advice. One way in which this happens is that an abundance of information overloads the consumer’s reasoning and emotions, resulting in unintentional nonadherence. Another way it happens is that the wealth of information bestows overconfidence, leading the consumer to subsequently listen less well to qualified experts and discount expert views different from their own mistaken conclusions.
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