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Compliance

1 Definition

  • Patient care: same as adherence: “consistency and accuracy with which a patient follows the regimen prescribed by a physician or other health professionalâ€?


  • Physics: “a measure of distensibility of a chamber in volume per unit change in pressureâ€?


(Source: 1 )


2 ….with Prescribed Medicine

Compliance with prescribed medicine is around 50%

  • Problems with regimen (for example adverse effects, complexity of regimen, etc)
  • Poor instructions
  • Poor provider-patient relationship
  • Poor memory (“forget to take itâ€?)
  • Patient’s disagreement with need for treatment or inability to pay for it
  • Making care for patient more convenient
  • Give material information (specific to the patient’s need and concern) & counseling
  • Reminders
  • Self-monitoring
  • Reinforcement
  • Family therapy
  • Psychological therapy
  • Crisis intervention,
  • Manual telephone follow-up
  • Other forms of additional supervision or attention.

(Source: 2)


3 The Critical Issue is: Good Provider-Patient relationship

--> Teamwork, patient feels part of team --> takes ownership of health What is needed? Good communication skills! Patient centeredness!

Doctor’s role: Provider of expert information and advice, acting often as facilitator

Interesting Research Finding: Telling patients about potential adverse effects of medication did not affect the use of the medication

(Source: 2)


4 Research Standard

Adherence is to be judged by clinical benefit, not simply by effects on adherence rates

(Source: 3)

  • Antibiotic prescribed: 1 Tablet QID (4 times a day) for 1 week
  • But patient takes only 1 Tablet BD (twice a day) for 5 days,
  • The adherence would be 36% (10 / 28 = 36%).
  • (Source: 2)

5 Sources & Further Reading

  • 1) Dorland’s Concise Medical Dictionary 2.0
  • 2) Haynes RB, Yao X, Degani A, Kripalani S, Garg A, McDonald HP. Interventions to enhance medication adherence. The Cochrane Database of Systematic Reviews 2005, Issue 4. Art. No.: CD000011.pub2. DOI: 10.1002/14651858.CD000011.pub2 Abstract Cochrane Library
  • 3) NHLBI (National Heart, Lung, Blood Institute Working Group) on Patient Compliance. Management of patient compliance in the treatment of hypertension. Hypertension 1982; 4: 415-23 Abstract on Pubmed

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