• Ozzie Paez

Communication and patient compliance

Numerous studies have identified poor communication between doctors and patients as a key contributor to low patient compliance with hypertension diagnostic and treatment protocols. This finding is common in other fields where experts attempt to inform and influence audiences from different cultures, education levels, language skills, etc. In this context, medicine is not alone.

Effective communication between doctor and patient is indispensable, but not enough. Other issues undermining patient compliance include the inconvenience and frustrations of multiple appointments, lengthy timelines, costs, and physical discomfort. Legacy Ambulatory Blood Pressure Monitoring (ABPM) technologies employ pressure cuffs that inflate every fifteen minutes over the 24-hour monitoring period. Patients have complained that the process can be painful and uncomfortable, especially during sleep. As a result, almost a third of patients (30%) fail to complete legacy blood pressure profiling protocols.

Compounding these barriers is hypertension's lack of symptoms. Unlike other illnesses and conditions, hypertensive patients demonstrate few if any symptoms until much of the damage is done. Equally important, while hypertension’s damage usually becomes evident in the future, the downside costs are felt in the present. Historically, humans have notoriously traded long-term benefits to avoid short-term inconveniences, costs, pain, and discomfort.

In other words, patient non-compliance may not be strictly rational but is tragically predictable given the state of legacy technologies and practices. These outcomes are anchored to aspects of human decision-making that I have studied, researched, and applied across domains over many years. If medicine wants to change the trajectory of hypertension as a threat to public health, then it must address and overcome patient decision-making dynamics. Innovative remote patient monitoring and profiling technologies like BioBeat’s 24BP are creating unprecedented opportunities for doctors to engage and collaborate with their hypertensive patients.

The contrast between legacy and cutting-edge blood pressure monitoring technologies shows great promise because products like 24BP eliminate many of the decision-making barriers behind patient non-compliance. This empowering story is reflected in Table 1’s data. I will illustrate their application and decision-making implications through a representative hands-on case in upcoming posts.

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