Why Patient Recall is the Key to Patient Engagement Especially in Chronic Care Planning

Healthcare providers have long been aware of the importance of having good communication with their patients. It is clear that when patients do not understand or remember the instructions they’ve been given, it can lead to poor health outcomes.

When patients don’t recall the instructions they’ve received, they are less likely to take medications as prescribed, follow recommended lifestyle changes, or get recommended screenings. This can put their health at risk.

Additionally, miscommunications between patients and providers can lead to frustration and decreased satisfaction with care.

But what exactly are the drivers behind this information gap?

Causes of miscommunication

Studies have shown that anywhere from 40-80% of information that a healthcare practitioner provides to the patient is forgotten immediately. [1] What’s more, almost half of the information that the patient does recall is recalled incorrectly.

The primary explanations behind this information gap are the following:

Clinician-driven. Factors relevant to the practitioner’s communication, such as the use of medical jargon, can affect how much information the patient retains.
Delivery of information. This can include whether or not the information was spoken, or provided to the patient in writing.
Patient-specific factors. Aspects such as the age of the patient, their stress levels, or their level of education will also affect the recall rate.

What are the effects of patient miscommunication?

When patients can’t recall the medical data they receive from their clinician, it can have devastating consequences for their health.

Poor patient recall can lead to:

Non-adherence to medication. If the patients cannot remember the specific instructions, it is doubtful that they’ll take their medication as prescribed. This is particularly worrying in chronic care cases, where patients will often have complex treatment plans.
Poor lifestyle choices: Patients who do not understand or remember the instructions they’ve been given are less likely to make the healthy lifestyle changes recommended by their practitioner, which might be critical in controlling their chronic illness.
Missed follow-up appointments, screenings or vaccinations. If patients forget or misunderstand the importance of these appointments, they may forego potentially life-saving preventive measures.
Decreased satisfaction with care. When patients don’t feel like they understand their care plan or don’t feel in control of their health, they are less likely to be satisfied with the care they receive.
Inability to participate in shared decision-making.

Patients who understand and can accurately remember the information given to them have a better chance of being engaged in their own healthcare. This will provide a higher likelihood of patient engagement, and they are more likely to use self-management techniques to actively participate in their health plan.

Proposed solutions for improving patient recall

The studies that look into why patients recall such a small proportion of the information given also shed light on the possible solutions that can help to change this.

With older patients, memories tend to fade rapidly, so practitioners should not leave a long time between when they provide information to the patient and when they seek their decision.
Anxiety levels can result in poor memory performance. It is often unavoidable in the cases of a challenging diagnosis or chronic conditions. In these cases, it might be helpful to duplicate the information through another medium, such as video or audio, so that the patient can review it at home when they are relaxed and better capable of taking it in.
The more information given to the patient, the lower the proportion that will be correctly remembered. For this reason, the clinician needs to establish what information the patient needs to know and make sure that they don’t provide more than that.
Interactions where the practitioner maintains verbal dominance of the conversation result in a lower recall rate. [2] Using communication techniques that keep the patient engaged, such as asking them to repeat what they’ve understood, will result in a higher recall.
Specific instructions are better recalled than general statements.
Medical advice is often given verbally, but this is not the optimal form to ensure high levels of recall. Written information is better remembered, and other mediums such as cartoons, pictographs, videos, or audio can be used alone or combined depending on what is more suitable for the patient.
Patients tend to focus on what seems more medically critical, like a diagnosis. This means that they will be more likely to forget the instructions they receive for treatment, so providing them in other mediums that they can take home can be of help.

Today, there are software solutions on the market, such as Complex Care Plan, [3] that can facilitate the viewing of patients’ Electronic Medical Records (EMR) and allow for smoother communication between physician and patient. These tools allow patients to participate more meaningfully in managing their own health.

By improving communication in healthcare settings, we can ensure that patients receive the care they need when they need it.