By Svetlana Sergeeva, project coordinator at the All‑Russian Patient Union for the development of patient NGOs.
For treatment to be successful and drug therapy effective, doctors and patients need to work together. Why do the two sides see communication so differently, and how can this be fixed?
The public’s demands and expectations of medicine are rising, but real‑world practice often falls short, Sergeeva writes. Anticipating and understanding changes in healthcare directly affects both patient adherence to treatment and the very decision to see a doctor. A number of subjective and objective obstacles stand in the way of mutual understanding in the doctor‑patient relationship.
The All‑Russian Patient Union has developed a three‑component model for building patient responsibility, comprising informational, personal and behavioural modules. Based on the algorithms developed, NGOs will be able to implement social programmes that make doctor‑patient cooperation more effective.
Informational module
First of all, a person must be well informed not only about their disease but also about their rights, Sergeeva says. This approach raises knowledge levels and translates that knowledge into real action. Patients often cannot put into practice even the information they have. For about 10 years, a patient rights helpline and the Union’s patient navigator have been operating, providing important support for
Personal module
Much – if not everything – depends on the patient’s emotional and psychological state, Sergeeva notes. It is important to teach patients to be more mindful, to understand themselves, to develop emotional stability and to increase their level of resourcefulness. But this is impossible without addressing another task: building the willpower to continue drug therapy over the long term to achieve the desired outcome. Within the personal module, the “Responsible Patient Notebook” has become very popular. It includes information on rights, exercises for building personal adherence and habits. The highlight of the notebook is a checklist for preparing for a doctor’s appointment.
Behavioural module
This module focuses on putting knowledge into practice and following a recommended lifestyle, Sergeeva explains. Everyone knows what a healthy lifestyle means, but a patient with a chronic disease often cannot live that way – they need to follow the doctor’s recommendations. That is why Union experts introduced a new concept: following a recommended lifestyle based on individual physician prescriptions. Game‑based and practice‑oriented formats are used, including a series of board games aimed at understanding patient pathways and building sustainable habits, such as “Small Steps – Big Results”. For a wider audience, the “Responsible Patient” quiz has been introduced, engaging people interactively on health issues and treatment adherence.
The communication issue
If you analyze reviews on medical organisation websites, many patients, when describing doctors, focus precisely on communication, Sergeeva writes. People expect not just polite interaction – they want to be heard, to have their questions answered, and to be invited to discuss an action plan. It is important to learn how to prepare for a doctor’s appointment so as to address all issues within 12 minutes – the standard time allocated for a consultation.
The responsible patient model needs to be promoted not only among chronic patients but also to the general public, Sergeeva says. With support from the Presidential Grants Fund, the All‑Russian Patient Union has already implemented several projects. More than 500 heads and leaders of patient NGOs have been trained, have mastered the technologies and are putting them into practice.
Tests for doctors on patient rights and levels of responsibility have also been developed, with input from sociologists and healthcare experts, Sergeeva notes. According to 2025 monitoring data, patients who have been interacting with NGOs for more than six months show positive changes in behavioural characteristics. More pronounced results are seen in regions where the tools are applied systematically. Today, Union initiatives are being implemented in more than 60 regions of Russia with the support of medical organisations.
Undoubtedly, the responsible patient position brings great benefits both to the individual and to the healthcare system, Sergeeva concludes. The important thing is not to wait for the “responsible patient” to arrive, but to work to make such an attitude the norm and part of our daily lives.