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Comment & Response
October 2014

Improving Medication Adherence and Helping Patients Make Lifestyle Changes

Author Affiliations
  • 1Albert Einstein Medical Center, Philadelphia, Pennsylvania
JAMA Intern Med. 2014;174(10):1708. doi:10.1001/jamainternmed.2014.684

To the Editor As an internist who has spent time and energy in helping patients (often successfully) modify risk factors, I was sad to learn about the negative results of the “House of Education.”1 On the basis of my clinical experience, I have some thoughts about improving the success of this program and of future ones.

Changing habits (smoking, eating, moving our bodies), even with patients who have just experienced an insult to their hearts, may not happen just based on factual learning. Often these changes occur because of emotional, experiential learning. Physicians who have a long-standing relationship with their patients may be better able to connect with them and help them change. Years ago, it was discovered that “the most frequently used drug in general practice was the doctor himself.”2 Although nurses and dieticians can play important roles in helping patients make changes, involving the patient’s primary care physician also (after they have undergone an educational program) might have brought a better result.

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