Both the American Diabetes Association (ADA) and the United Kingdom’s National Institute for Health and Care Excellence (NICE) have recently placed greater emphasis on individualizing care. The ADA uses “patient-centered care” in their standards, and NICE supports having individuals involved in diabetes-related decisions. We’ve been discussing putting people with diabetes at the center of their care for years, and it’s very exciting that these prestigious organizations are getting behind it.
So why are we still seeing and hearing the word “adherence”? It seems like these messages of patient-centeredness are going in one ear and out the other when health care providers still use terminology that is outdated and inappropriate in diabetes care. Adherence, like compliance, means “sticking to” something that someone else wants us to do. How is that patient-centered?
It’s time for health care professionals to take a look at our spoken and written language and figure out how we can align it with the messages we are meaning to send. If we want to give patient-centered care, then let’s also use patient-centered language. Let’s send messages that reflect an empowerment, strengths-based approach.
Some examples include “she is taking her medication about half the time” or “he takes insulin when he can afford it” rather than “she/he is not adhering to the plan” (or even “she/he is non-compliant”). And how about “medication taking” rather than “medication adherence”? These small changes add up to focusing on a person’s strengths, instead of their weaknesses.
Groups like the ADA and NICE have made giant steps toward improving care for people with diabetes, and this is to be commended! The next step is to adopt language that sends messages consistent with a patient-centered focus.