How physicians can improve patients' participation and maintenance in self-care

A protocol for the stepped education and support of patients is derived from the cumulative experience of more than 200 clinical trials of patient education and behavioral change interventions. The recommended procedure entails assessing a patient's educational needs by asking a sequence of "diagnostic" questions to assure patient motivation, skill and resources and to reinforce adherence to the prescribed medical regimen or life-style modifications. The sequence of questions and interventions is also designed to minimize a physician's time commitment and to maximize the medical benefit to the patient.