Lost in Translation – understanding cultural and linguistic differences for successful adherence programmes

We love the movie ‘Lost in Translation’ with Bill Murray, it really captures how things can go wrong and easily be misunderstood with differences in culture and language.

Running adherence programmes internationally requires a deep understanding of the role of culture and language. Cultural and language differences have a direct impact on how successful an adherence program will be. It is hard to be aware of every single aspect of each country’s culture from afar. That’s why we really do take this factor into account and have an international team in place to create effective programs efficiently.

It is good to remind ourselves that in life, communication is key to success. Being aware of cultural backgrounds is key to the adoption and use of programmes. Direct translation rarely effectively translates all intended meaning. This is also why we conduct research, because customer needs and demands, decision making, and social role views all varies by culture, and to understand the exact words and meaning ascribed to those words in the language and context the program will be

We have yet to find a better way than using people who are native speakers of the language, have been immersed in the culture and are trained in the underpinning psychological constructs.


Importance of the person-centred approach

As the world becomes increasingly entrenched in big data, one must stop and ask – what will happen to our individuality? This 2-minute whiteboard video will discuss these issues and highlight the importance of the person-centred approach.

Adherence: transforming cure into care

Within the field of medical adherence, we become equipped with the phrases to explain the importance of what we do. We learn the chorus: approximately 50% of patients do not take medicines they are meant to; communication barriers between clinicians and patients can leave adherence unaddressed; poor adherence leads to increased morbidity and mortality. Swimming in p values and questionnaires and segmentation, it is sometimes easy to forget the worth of empowering patients by investigating non-adherence to our patients.

The need for patient empowerment is echoed throughout healthcare and we know that involving patients in conversations about adherence is part of this. Many of the constructs that define patient empowerment, such as personal control and self-efficacy, are synonymous with the theories behind Spoonful of Sugar (SoS) frameworks that measure and understand adherence. If knowledge is power, then our frameworks enable us shape adherence programmes in a way that responds to and gives weight to our patients’ needs and values. But what worth does this hold for patients?

By listening to what patients think about their medication regime, we add value to how patients feel, and appreciate how complicated this can be. As someone whose medical files are laced with finger-tip-unit-only steroids, count-to-five-between-puffs inhalers, and “I nag because I care” relatives, it is comforting to know that adherence studies humanise us. Our researchers remove the fear of stigmatising labels such as “lazy”, “ignorant” and “ungrateful” by understanding the complexity of behaviour. Our approach breaks down the “them” and “us” wall between healthcare professionals and patients. We encourage empathetic care and create opportunities to share repressed worries and frustrations. Our knowledge of adherence does empower patients, but ultimately, we ensure cure is transformed into care.

There is no p value to measure the relief we feel when we can voice our thoughts on our treatment, but the significance of being understood cannot be over stated.