Communicative strategies for improving compliance in long-term management of optic nerve disease
DOI:
https://doi.org/10.31288/Ukr.j.ophthalmol.202657782Keywords:
optic nerve, compliance, the SPIKES protocol, vision diary, neuroophthalmology, healthcare communicationAbstract
Introduction. Effective physician-patient interaction is a critical factor in the management of chronic disorders. In neuroophthalmology, a lack of structured communication and patient’s psychoemotional catastrophization caused by the fear of the loss of sight can result in poor treatment compliance and treatment dropout.
Purpose. First, to demonstrate our clinical experience in the use of a combination of communication strategies based on the adapted SPIKES protocol, for improved long-term treatment compliance in patients with severe optic nerve pathology, and, second, to justify the significance of these strategies as an essential component of the rehabilitation roadmap.
Methods. The present study reviews the long-term management of six patients with severe optic nerve pathology. A six-step algorithm of the SPIKES protocol for communicating the diagnosis and prognosis adapted for a linguistic “low marginality” concept (with treatment success defined as the preservation of residual functions) was introduced onto clinical practice in combination with daily “Vision diary” keeping by patients.
Results. The use of a communication rehabilitation model developed enabled achieving a mean personal adherence rate of 88.4% at 6 months.
Conclusion. The SPIKES protocol integrated with the “Vision diary” is an independent and justified component of rehabilitation programs. This integration transforms the paradigm of doctor-patient interaction, restoring a patient’s sense of control over the disease and maximizing therapy adherence.
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