When patients don’t follow through with recommended treatments, medications, lifestyle changes, or follow-up plans, the consequences can ripple through patient health and practice outcomes. Understanding the underlying reasons and applying practical patient-centered solutions can help practices close this gap and improve the quality of care.
Even the most carefully tailored care plans aren’t always followed once patients leave the exam room. When patients don’t follow through with recommended treatments, medications, lifestyle changes, or follow-up plans, the consequences can ripple through patient health and practice outcomes. Understanding the underlying reasons and applying practical patient-centered solutions can help practices close this gap and improve the quality of care.
What happens when patient care plans aren’t followed?
Non-adherence isn’t just a minor hiccup; it’s a significant challenge for both patient health and practice performance. It can lead to disease progression, preventable complications, hospitalizations, and higher healthcare costs. Studies show that poor adherence contributes to worse clinical outcomes and a significantly higher disease burden, particularly for chronic conditions like diabetes, hypertension, and cardiovascular disease.
When patients don’t follow their care plans, it impacts not just outcomes—but physicians, care teams, and practices as well. For practices, non-adherence means not only poorer patient health but also negative impacts on quality scores, patient satisfaction, and overall care costs. Fixing the root causes of non-adherence is vital to keeping patients healthier and reducing avoidable strain on clinical teams.
What are the main causes of non-adherence to care plans?
When patients don’t follow care plans, it’s rarely due to rebellion or apathy. In most cases, patients aren’t ignoring their plans; rather, they often misunderstand them, can’t prioritize them, or struggle to follow through amid competing demands.
For example, up to 27% of prescriptions go unfilled, not because patients refuse them, but because affordability remains a major barrier. 1 in 4 patients struggle to afford their medications. Some of these issues are systemic and beyond physicians’ realm of control. However, many barriers patients face when implementing care plans are within physicians’ influence.
Here are some common hurdles patients face and how physicians and practices can address them:
Lack of understanding
Patients may not fully grasp why a care plan matters, how each step fits together, or how to carry it out correctly. Health literacy gaps and unclear communication are strongly linked to non-adherence. This can range from not knowing what a certain medical term means to not understanding how to practically implement the instructions.
Solution: Provide teach-back education. Ask patients to repeat instructions in their own words to confirm comprehension. Use visuals, simplified language, and printed or digital summaries of instructions. Integrating patient education tools into the EHR workflow and reinforcing instructions through follow-up calls can further improve comprehension.
The plan doesn’t fit into their lifestyle
Many care plans assume a level of time, stability, or routine that patients may not realistically have. If a treatment plan disrupts daily routines—or doesn’t account for work, family, or other responsibilities—patients are far less likely to follow it.
Solution: If a patient shares that a care plan isn’t working with their lifestyle, listen without judgment or blame. Even if these struggles aren’t directly communicated to you by the patient, signs of them may be present—so be sure to investigate further when needed. When issues are identified, collaborate with patients on realistic, personalized modifications. Shorten regimens where possible, align medication timing with daily routines, and introduce shared decision-making to co-create achievable steps.
No reminders or follow-up after the visit (lack of ongoing engagement)
Patients often forget instructions or appointments once they leave the clinic, as everyday responsibilities quickly take priority. Unengaged or unsupported care journeys are a major contributor to non-adherence.
Solution: Implement automated reminders for appointments and medication schedules, and schedule check-in calls or messages shortly after visits. Leveraging patient engagement platforms that deliver personalized, timely reminders—especially via mobile—improves follow-through and accountability.
Medication barriers
Practical obstacles to obtaining and staying on prescribed medications, such as cost, transportation, side effects, or dosing confusion, frequently disrupt adherence.
Solution: Identify barriers early through screening questions and offer solutions such as prescribing lower-cost alternatives, connecting patients to financial assistance programs, or simplifying regimens. Tools like RXnotify can help patients track refills, receive cost alerts and savings opportunities, and get transparent information about their prescriptions. Additionally, coordination with pharmacists for counseling can demystify side effects and dosing issues.
Lack of trust or confidence in the provider’s decision
When patients don’t feel confident that a care plan aligns with their needs or feel unheard—trust erodes quickly, and adherence drops before the visit even ends.
Solution: Build trust through shared decision-making. Ask about patient goals, concerns, and preferences. Validate their experiences, explain the evidence behind recommendations, and tailor plans accordingly. Consistent, empathetic communication is one of the strongest predictors of patient adherence and long-term engagement.
Information overload
During a typical visit, patients may receive a large volume of complex information in a short amount of time. The information can be unexpected and emotionally charged, leading to overwhelm and a drop-off in follow-through.
Solution: Break information into bite-sized pieces. Focus on two to three key actionable steps per visit, provide take-home materials like brochures or instruction sheets, and reinforce messages through follow-up communication. Use patient portals, short videos, or mobile apps to deliver staged education and reduce cognitive load between visits.
Technology that Helps Patients Follow Their Care Plans
When patients struggle to follow care plans, the issue is rarely a lack of motivation—it’s a lack of ongoing support. From confusing instructions to medication barriers and missed follow-ups, non-adherence is often a systems problem, not a patient problem.
RXNT helps practices close these gaps by simplifying prescribing, improving communication, and supporting ongoing engagement beyond the visit. With tools that streamline e-prescribing, reduce medication confusion, and keep patients connected to their care, RXNT enables practices to turn care plans into care actions. By meeting patients where they are and removing friction at every step, practices can improve adherence, outcomes, and trust while delivering better care for everyone involved.
