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Comment & Response |

Improving Medication Adherence and Helping Patients Make Lifestyle Changes

Ronald S. Banner, MD1
[+] Author Affiliations
1Albert Einstein Medical Center, Philadelphia, Pennsylvania
JAMA Intern Med. 2014;174(10):1708. doi:10.1001/jamainternmed.2014.684.
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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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October 1, 2014
Ariel Cohen, MD, PhD; Patrick Assyag, MD; Isabelle Boutron, MD, PhD; for the Réseau Insuffisance Cardiaque (RESICARD) PREVENTION Investigators
1Service de Cardiologie, Hôpital Saint-Antoine, Assistance Publique des Hôpitaux de Paris (AP-HP), Université Pierre et Marie Curie, Paris, France
2Currently in private practice, Paris, France
3Centre d’Epidémiologie Clinique, Hôpital Hôtel Dieu, Assistance Publique des Hôpitaux de Paris, Paris, France4Institut National de la Santé et de la Recherche Médicale Unité 738, Paris, France5Faculté de Médecine, Université Paris Descartes, Sorbonne Paris Cité, Paris, France
JAMA Intern Med. 2014;174(10):1708-1709. doi:10.1001/jamainternmed.2014.651.
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