Remembering your Treatment
Getting the most of healthcare requires not just effective work on the part of care providers to administer treatments but also the ability of patients to follow through on treatment instructions and general long-term advice. A great number of environmental and socioeconomic factors may intervene in the ability of providers to get care to patients or the ability of patients to afford treatment, however, another factor more fundamental to human nature also plays a significant role in introducing inefficiency to care delivery.
Human memory is imperfect, to say the least. It is impractical to assume that patients can be expected to remember every piece of information from their doctor about treatment instructions and advice. For those who do not organize notes about their care visits and treatment (a demographic that includes many Americans), this means that a great deal of the expertise shared in treatment instructions and advice can never be put to use.
One Brown University study sought to grasp how much information patients can recall from care visits. By reviewing the transcripts of outpatient care visits and interviewing patients 1 week after, the researchers focused on how much information patients could remember from these visits.
Of the patients, only 49% could remember decisions and recommendations from care visits without any assistance. When prompted with hints, another 36% of subjects could recall decisions, leaving a whole 15% who either remembered information incorrectly or simply did not remember anything.
Factors Affecting Memory
Understanding and getting to the root of the challenges of poor patient recall rates means considering how the human capabilities of memory act during and after care visits.
Typically, memory is understood in the context of three stages where a new memory is encoded, stored, then retrieved. Countless events, actions, and factors can interfere with these processes, which makes human memory extremely imperfect.
For example, if too many items are discussed in a care visit, it seems reasonable that a patient will not remember everything. The capacity of short term memory may simply not be enough to make it into a person’s long term memory. Combined with the primacy and recency effects, and patients may be leaving care visits remembering only the first or last items discussed.
A great deal of research has also linked the correlation between stress and memory. Too little attention paid would of course allow details to slip through the metaphorical cracks of memory encoding, but subjects under too much stress have also been found to have a harder time making high-quality memories.
Older age has also been correlated with a weaker ability of subjects to make and recall memories, which poses concerns for the patient recall capabilities of seniors. In a healthcare space where providers are constantly busy, it is also likely that insufficient face-to-face time with care providers may be leading to less meaningful interactions which would otherwise allow for more sensory details and encodings to make recall in the future easier.
The Long Term Cost of Poor Recall
No discussion of the limitations of healthcare delivery is complete without a discussion of the long-term effects of such challenges. As it becomes evident with any look at obstacles in equitable improvements in healthcare, small factors like poor recall have the potential to compound with other activities.
This could mean something as (relatively) harmless as forgetting to inform a new doctor about certain details of a past treatment you may have had with another doctor. In some cases, this has the potential to contribute to wasted resources in duplicated treatment recommendations or even potentially disastrous reactions coming from treatments informed by insufficient information from the patient’s memory.
For patients seeking significant improvements in lifestyle or attempting to treat complex conditions, it may simply be unfeasible to manage complex care plans which have carry a great deal of information on treatment instruction and guidance.
All of these inefficiencies have the potential to add up over time. The inability to complete complex care plans or follow through on recommendations for lifestyle change simply due to poor recall has the potential to pave the way for health complications down the road which could be completely avoidable had necessary steps been taken to improve recall.
It’s of course not all doom and gloom. A number of techniques and behavior modifications can improve patient recall. Taking notes and organizing information from care visits can be a great source for referencing treatments in the past. Taking time to engage with doctors and other health professionals for personalized discussion about recommendations and guidance or even quickly reviewing discussed points all the have the potential to pay off in quality of care and long-term wellness.
