The Psychology of Lab Results on Patient Adherence

Laboratory testing is a central component in guiding patient care and treatment decisions, with some studies suggesting that up to 70% of today’s medical decision-making may be affected by lab results. Various types of laboratory testing can now provide insight into basic health biometrics, hormone levels, micronutrient levels, and so much more, helping both practitioner and patient better understand what’s happening when it comes to their health. Results also have the potential to help improve patient adherence by helping patients make sense of various symptoms and understanding how their treatment plan reflects the data found with lab testing.  Additionally, re-testing labs can help patients see their progress and motivate them to continue healthy habits. However, there is also the possibility that negative lab results could distress patients who are experiencing symptoms and discomfort, making it important for providers to build trust with patients and not rely solely on lab testing for treatment decisions.

It should be noted that ‘adherence’ differs from the oft-used term ‘compliance’ when it comes to patient behavior. Patient adherence refers to the active choice of patients to follow through with treatment recommendations while taking responsibility for their own health and wellbeing; compliance is more of a passive process that refers to patients listening to a set of instructions given by a provider.  The words are often used interchangeably in the literature; but for the purposes of this article, we will be referring to patient adherence per the description above. 

Understanding Patient Adherence

Patient adherence refers to how well a patient’s behaviors align with their healthcare practitioner’s recommendations for health advice. While diagnosis and creation of a personalized treatment plan are integral to providing optimal care, adherence is key to patients getting the benefits of those treatment plans. Nonadherence can result in scenarios such as underuse of medications or supplements, continuing unhealthy habits that are contributing to disease progression, or other situations where patients may not see optimal outcomes as a result.  

Many different factors may influence patient adherence, including psychological, social, or environmental factors. Patients may not understand the reasons for their treatment recommendations, or may not understand the extent of their current condition if it is not communicated in a way they understand. Additionally, if there is a lack of trust in the patient-provider relationship and patients do not feel satisfied with the care given to their case, adherence is also less likely to occur. Recommendations that might seem difficult for patients to integrate into their current lifestyle, or that require them to stop doing things they enjoy, can also lead to nonadherence at times. Patients who don’t have a good support system are also at risk for nonadherence, especially if they have a complex treatment plan. The environment may also play a role in patient adherence - if it’s difficult for patients to access different treatment modalities, they are oftentimes nonadherent with provider recommendations.

Ultimately, it’s not as simple as telling a patient what to do - providers and healthcare teams need to help patients connect the dots as to why recommendations are being made and help them see how new habits can fit into their current lifestyle.

Psychological Impact of Receiving Lab Results

Patients may experience a variety of psychological responses upon receiving lab results, including anxiety, relief, or denial. Learning of abnormal results may induce anxiety in patients who aren’t sure what those results mean for their health and well-being moving forward, and they may be concerned about managing an illness or a tough diagnosis. Getting normal results may also lead to anxiety in patients who are experiencing frustrating symptoms that are interfering with their daily lives, as they may have been hoping to find a definitive answer as to what is causing those symptoms. 

Sometimes, results that point towards a difficult diagnosis may even result in denial, with the patient refusing to believe that anything is wrong or refusing to acknowledge the severity of their disease. This is often a self-protection mechanism, and providers need to ensure the patient truly understands the scope of their situation so the patient can make the best decision regarding their health. 

Conversely, patients may also experience massive relief from their lab results. Finding out one has a clean bill of health can alleviate any anxiety or worry about the state of one’s health. From a different perspective, learning that one’s lab results show a reason for their symptoms can also lead to relief at finally having an answer, meaning the patient can now start on a treatment plan to help them feel better. 

Lab Results and Health Behavior Change

Seeing lab results and understanding their interpretation can catalyze health behavior change. A 2022 study found that patients receiving educational interpretation of their lab results had a higher rate of adherence (71%) compared to patients who only received lab results (49%), making it clear that communicating lab results is a key aspect of patient adherence and behavior changes. Lab results can be motivating for many patients, providing something tangible that gives insight into what’s happening with their health and areas that they can work on improving to feel their best.

Different theories on health behavior change can be applied to the concept of lab results and patient education. For example, the Health Belief Model is a framework that suggests that patients will change their behaviors if educational guidance targets their perceived barrier to change, benefit comprehension, self-efficacy, and threat. Essentially, if providers can communicate lab results in a way that helps patients understand what their abnormal results mean, the benefits of making changes to address those results, and how they can take action to impact their health in a way that addresses potential barriers to change, the likelihood of patient adherence will be higher than if these topics are not addressed. Comprehension is key, and it’s not enough to just send patients lab results without any explanation as to how those results fit into the bigger picture of their health journey. 

Communication of Lab Results by Healthcare Practitioners

Communication skills and emotional intelligence are essential for practitioners when it comes to discussing lab results with patients. Having strong communication skills forms the foundation for a positive patient-provider relationship, leading to more patient trust and better overall outcomes. To effectively communicate lab results to patients, healthcare practitioners need to make sure they are speaking using language the patient understands, while also regularly pausing to check in on patient comprehension of their results. Different patients have different levels of health literacy, learning preferences, and expectations of the patient-provider relationship, and taking the time to understand where patients are is an important component of how to communicate and share results with those patients. Allowing patients to ask questions and share their understanding (or lack thereof) about their results - active listening on the part of the practitioner - can improve patient satisfaction, ease anxiety, and help engage patients to comply with their treatment plans.

Enhancing Patient Adherence Through Education

Patient education can help to improve patient adherence, particularly following the delivery of lab results. Many patients do not have the medical background to understand what their lab results mean within the bigger picture of their health history and current symptoms, and providers need to educate patients on the implications of their lab results. When patients understand why tests are ordered, what their results mean, and how those results are integrated into a treatment plan, it’s more likely that patients will adhere to treatment recommendations.

There are many different ways to provide patient education following their lab results. 

The provider can educate the patient directly during patient visits, or members of a care team who are educated on interpreting lab results can direct these educational visits. Providers may also record video content to help patients better understand their lab results or provide hard copies of educational material for patients to read, based on patient preference for learning. Using patient teach-back is another strategy that can help educate patients and improve adherence. During patient teach-back, providers explain an important concept and then have the patient repeat the concept in his or her own words, helping to show if the patient truly understands what the provider is saying.  

The Role of Patient-Provider Relationship

A key part of effectively increasing adherence to a patient’s treatment plan is the relationship between patient and provider. Patient trust has a positive effect on their confidence in a treatment approach, increasing the likelihood of adherence to that plan. While lab results can be an important part of the picture in effective diagnosis and treatment, the ability of a provider to effectively relay just what those lab results mean in a way that is aligned with a patient’s priorities is key to getting patients to adhere to a given treatment plan.

Understanding a patient’s communication style and learning style is an important aspect of building trust and strengthening communication between patient and provider. When patients feel safe and heard, it helps build trust in their providers and increases the likelihood of following recommended treatment protocols. Paying attention to patients’ perceived barriers to adherence allows the provider to educate and empathize with how the patient is feeling, and figure out a way to make the treatment plan work by overcoming those barriers.  

Overcoming Barriers to Adherence

It’s important to consider common barriers to patient adherence following the delivery of lab results. Barriers can range from patient forgetfulness or anxiety about a treatment modality to low motivation, experiencing adverse effects, or having poor health literacy and not understanding why treatments are being recommended.  

There are a variety of ways that providers and care teams can help patients overcome these barriers and increase patient adherence. Patient-centered care approaches that prioritize patient education, active listening to address patient worries and concerns, and provider-patient partnership can all help to build trust and improve health literacy, thereby increasing the likelihood of patient adherence. Regular monitoring and check-ins with patients by a care team can help patients feel more supported and address any potential roadblocks in complying with a treatment plan, such as side effects of medication. Additionally, automatic reminders about appointments or medication use can help take the pressure off of patients to remember everything on their own, while support systems and groups may ease anxiety and help patients find community around their health goals.  

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The Psychology of Lab Results on Patient Adherence: Final Thoughts

Lab results can lead to a variety of reactions in patients, ranging from feelings of relief to anxiety or even denial. Communicating lab results requires not only delivering results themselves but also educating patients on what results mean and how they fit into the bigger picture of their treatment plan. Providers must have an understanding of various patient barriers to adherence so that these may be addressed after delivering lab results and a treatment plan. A strong patient-provider relationship built on trust and regular follow-up with patients goes a long way to fostering adherence after patients receive lab results.