Key Takeaways
- Discuss treatment adherence in a neutral, non-judgemental way.
- Find out whether the difficulty relates to concerns, practical barriers or both.
- Explain how the treatment connects with the patient’s own health goals.
- Agree on realistic changes rather than giving another lecture.
- Review the plan and invite the patient to discuss problems honestly.
Introduction
Treatment adherence can be difficult to discuss. When a patient has missed medication or stopped treatment, repeating the instructions more firmly may feel like the obvious response.
However, the patient may already understand. They may be experiencing side effects, struggling with routines or making a deliberate choice based on their priorities.
The aim is not to secure obedience. It is to understand what is happening and work with the patient on a safe, realistic plan.
NICE guidance on medicines adherence recommends assessing adherence routinely and without judgement. It also advises exploring whether missed treatment results from concerns about the medicine or practical difficulties in following the plan.
How to Encourage Treatment Adherence Respectfully
The following five steps can make the conversation more collaborative.
1. Ask Without Sounding Accusatory
Avoid questions that imply blame:
“Why haven’t you been taking your tablets properly?”
Try a neutral question that makes honesty easier:
“Many people find it difficult to take every dose. How have you been getting on with the tablets?”
Other useful questions include:
- “How often would you say you miss a dose?”
- “Is there anything about the plan that has been difficult to follow?”
Avoid terms such as “non-compliant” in conversation. They can make a complex situation sound like simple disobedience.
2. Identify the Real Barrier
A patient may intend to follow treatment but have difficulty remembering doses, opening packaging or fitting the plan around daily life.
Another may reduce or stop treatment because of side effects, beliefs or doubts about its value.
Ask:
- “What tends to get in the way?”
- “Do you have any concerns about taking this long term?”
- “Have you noticed any unwanted effects?”
This is where it helps to ask about a patient’s ideas, concerns and expectations naturally. Do not offer reminders to someone whose main concern is a side effect.
3. Connect the Treatment With the Patient’s Priorities
Generic warnings may sound like a lecture:
“You must take this or your condition will get worse.”
Instead, explain the likely benefit in relation to something that matters to the patient:
“Keeping your asthma controlled should make it easier for you to exercise without becoming breathless.”
Explain what the treatment does, when benefits may appear and what could happen without it. Avoid promising a result.
If the patient is worried about harm, use the same balanced approach described in How to Explain Medication Side Effects Without Alarming Patients.
4. Agree on a Realistic Plan
Ask the patient what change feels manageable. Possible options may include:
- Linking medication with an established routine
- Using a reminder or written schedule
- Reviewing the dose, timing or formulation
- Addressing side effects
- Involving a pharmacist or carer, with agreement
- Considering another clinically appropriate treatment
You could say:
“Which of these options would be most realistic for you?”
The GMC’s prescribing guidance advises agreeing which medicines are appropriate and how the condition will be managed, including review arrangements.
If an informed patient decides not to continue, avoid applying pressure. Explore the decision using the principles in How to Respond When a Patient Refuses Treatment.
5. Check Understanding and Review the Plan
Before finishing, clarify what the patient has agreed to do and how any difficulties will be handled.
For example:
“Just so I know I explained it clearly, could you talk me through how you’ll take the medicine from tomorrow?”
This helps you check patient understanding without sounding like a test.
At follow-up, ask directly about progress. If the plan has not worked, explore why without criticism and adjust it where clinically appropriate.
Short Model Conversation
Doctor: “Many people find it difficult to take every dose. How have you been getting on with yours?”
Patient: “I usually forget the evening tablet, and it sometimes makes me feel sick.”
Doctor: “Thank you for telling me. Which is the bigger problem for you—the timing or the nausea?”
Patient: “Probably the nausea.”
Doctor: “Let’s look at that first. I’ll explain what may be causing it, and we can discuss whether the plan needs adjusting.”
Common Mistakes to Avoid
Try not to:
- Assume that missed treatment reflects laziness or carelessness
- Ask questions that make the patient hide difficulties
- Repeat instructions without exploring the barrier
- Use fear or exaggeration to gain agreement
- Offer practical reminders when the main issue is concern about treatment
- Create a plan without involving the patient
Final Thoughts
Supporting treatment adherence begins with curiosity rather than correction.
Ask neutrally, identify the barrier and connect treatment with the patient’s priorities. Agree on a manageable plan and review whether it works.
Patients do not need another lecture. They need a conversation in which they can explain what makes treatment difficult.
If you would like to develop more confident ways of discussing adherence and treatment decisions, book a consultation to discuss your goals and see how I can help.
References
General Medical Council (GMC) (2021) Good practice in proposing, prescribing, providing and managing medicines and devices. Available at: https://www.gmc-uk.org/professional-standards/the-professional-standards/good-practice-in-prescribing-and-managing-medicines-and-devices (Accessed: 12 August 2026).
National Institute for Health and Care Excellence (NICE) (2009) Medicines adherence: involving patients in decisions about prescribed medicines and supporting adherence (CG76). Available at: https://www.nice.org.uk/guidance/cg76(Accessed: 12 August 2026).