How should we Adjust Treatment?

The usual purpose of monitoring is to detect when some change of management is needed and to make the appropriate adjustment. How much we adjust
will depend on the degree of change. Chapters 6 and 7 examined how we can
identify when a patient’s monitoring measurement is within a desirable target
range and how often we need to do this. In this chapter, I examine the next
link in this chain—understanding the options for adjustment of treatment
and how to make a reasonable choice between the options. The sequence to
consider is
1 whether the cause of the change is explainable through non-adherence or
another behavioural change;
2 whether to increase, add or switch therapies;
3 how much to increase (or decrease) therapy.
However, before we look at these it will be helpful to understand the problem
of worsening control that can occur with poor adjustment of therapy.