Rural Residents Becoming Less and Less Likely to Follow Oncologists’ Advice, Study Shows

It is supposed to be common knowledge that following your doctor’s instructions can improve your physical well-being, heal ailments, prevent future health problems, and even extend your life. However, with the increasing number of people who have ready internet access and the rise of the trend of trusting natural remedies over medical drugs and procedures, we’re seeing a large number of people begin to be wary of their doctors’ advice.

Jakob Jensen, Ph.D., professor in the Department of Communication at the University of Utah and member of the Huntsman Cancer Institute, was the senior author of a study on the topic of rural and urban patients’ beliefs and perceptions surrounding cancer-related medical information. The study found that rural residents tended to be far more wary of doctors’ intentions and knowledge, and they were therefore less likely to follow their oncologists’ cancer-related instructions and take their medications.

Pharmacy Times recently interviewed Dr. Jensen about what oncologists and pharmacists can do to address the concerns and beliefs of their rural patients.

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According to Jensen, rural residents are more likely to have fatalistic attitudes toward cancer care, and they often reject their doctors’ advice as a defense mechanism when they are dealing with information overload or inaccessibility of care. This gap widened significantly in 2009, causing the already most underserved populations to be the first ones to give up on preventative care.

“With rural adults, I think we have some genuine concerns that they’re becoming more anti-medicine, more anti-research, that they’re pulling away towards sometimes self-care models that are not the healthiest,” he says.

Jensen believes mobile mammography clinics and similar mobile screening units could help make things more accessible for rural residents. Mobile units can also pre-advertise with social media and posters to spread awareness and educate their target clients about what they do to emphasize the worth of going to a mobile clinic.

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“So, before we roll in, the mobile mammogram clinic will sometimes run a little pre-campaign before it ever arrives, [such as a] poster campaign or social media campaign that talks about the mobile clinic, that shows its numbers, how successful it’s been, how it’s reduced, for example, the stage of breast cancer that we identify in rural communities dramatically, how it’s improved outcomes—you must do some groundwork,” Jensen explains.

Follow-up is another aspect of care Jensen believes is vitally important. Some doctors even try to plan initial visits and follow-up care on the same day or the next day so that rural patients who have to travel significant distances can get it all done at once and not have to make multiple trips. Without a firm focus on follow-up, he says, two-thirds of rural patients will simply never come back.

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Jensen says the internet is sometimes useful to increase patients’ knowledge about their diagnosis, but using the internet for research also sometimes increases information overload and leads to burnout. It’s often best, he says, to simplify by telling patients what the two or three most important things they need to know are and warn them not to worry themselves by digging too deeply online.

Rural adults are more likely to be people of color, low-income people, elderly people, and people with comorbidities. They are already underserved, and their rural locations serve to move them even further from good medical care.

“If we don’t engage this issue, and just let it fester, there’s good reason to believe that it just gets worse over time,” says Jensen. “Here’s an important group, and they might need you more now than they’ve ever needed you. And they won’t always be easy to deal with, and they won’t always be easy to get to, and you might have to think in innovative ways to get to them, but when you can, there’s a lot of good that can be done.”

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