Importance of medical compliance in patients

Why patient non-compliance is so serious and how to fix it

What is non-compliance?

Patient compliance refers to how well a patient abides by the prescribed diet and treatment plan. It includes timely follow-ups, honest reporting, and taking your medicines in the right dosage, on time. Here is where you ask yourselves questions like: are you visiting your doctor frequently, how much of the facts do you let her know, and do you go back for future course of action, if needed? The treatment of chronic conditions is a global issue of a large scale. In developed countries, medical adherence is about 50% and in developing countries, it is even lower. Non-communicable diseases and mental disorders often go unreported altogether. Lack of adherence leads to poor outcomes and hikes in healthcare costs at all levels i.e. individual patients, healthcare providers and country.

Types of compliance

Adherence is undoubtedly an important factor in healthcare effectiveness. It is directly linked to the patient’s safety. While healthcare ecosystem must rise to the occasion and meet the compliance challenges head on, patients have a crucial role to play in as well.

Compliance can be broadly categorized into two parts:

  1. Treatment compliance:

    This includes visiting the doctor as per schedule, getting tests done on time, and doing what you’re asked to do, the right way, at a certain time and place.

  2. Medical compliance:

    The other part of compliance is taking the medicines as per doctor’s instructions.This involves taking the medicines on time, morning vs. evening, and in the right dosage, for example: 50 mg tablet or 100 mg.

The dangers of non-compliance

One cannot discount the dangers of patient-related non-compliance. Let’s go over them.

  • There may be more intense relapses which may worsen the illness and make the patient unresponsive to treatment.



  • It may increase the risk of patient inappropriate dependence on certain drugs. (For instance the use of diazepam and opioid-related drugs). According to an estimate, 8 people die every hour in the US due to the opioid crisis.



  • It may increase the risk of abstinence or rebound effect when medicines are abruptly discontinued as seen in hormone replacement therapy or treatment for hypertension or depression.



  • It increases the risk of developing resistance to therapies. For example, in the treatment of tuberculosis, poor adherence is factored in the cause of treatment failure, relapse, and drug resistance.



  • It increases the risk of toxicity. This is true for the elderly patients who experience altered pharmaco-dynamics and schizophrenic patients.



  • It increases the likelihood of accidents. Many medicine routines require lifestyle changes such as abstinence from alcohol. Not following that can cause severe side effects and lead to dangerous consequences.

Patient compliance is like a seat-belt. You wear it all the time even if never intend to get into an accident!

Let’s dig deeper - what does research say?

Many patients tend to miss timelines and don’t comply with medical advice unless they turn seriously sick. A cross-sectional study conducted on the adherence to medications in rural Kerala indicated that poor adherence was high because of patient-related factors. These included the socio-economic conditions of patients, reporting only symptomatic management, and not receiving enough family support. Interventions like lower expenditure, regular monitoring, better education, and enhanced family member support are critical to the proper management of diseases.

Another study done in Mumbai showed drug resistance among patients due to misuse of antibiotics. It may also be likely that patients experience frustration if their preferences in treatment-related decisions are not taken into account, such as preferring a tablet over an injection. It is important that you know the reason for what the doctor has prescribed you because they consider the pros and cons while writing the prescription. Empower yourself with ‘the why’ you are asked to do it and that extra bit of information might just help you stay on track with the prescription!

What must you do?

Another factor that is key to patient-related non-compliance is the patient’s understanding of the potential costs and the pros and cons of the treatment plan. Your motivation to follow through a treatment regimen lies in the value you place on it and the degree of confidence you place in the plan and its provider. Optimizing treatment outcomes is perhaps easier than you think.

Here’s some simple advice for both patients and caregivers.

  1. Educate yourself

    Staying informed about your condition, treatment alternatives, treatment benefits, and side-effects are key ingredients to the correct get-better-soon recipe.





  2. Build self-management skills

    If you want to be the captain of your ship, start valuing your physical (and mental) health and take into account every detail that concerns its functioning and performance. Self-care starts with self-love and moves into self-discipline and integrity.





  3. Ask for help.

    Asking for help is implicitly regarded as a sign of weakness, incompetence and vulnerability. However, it is proven that people in most cases openly help when asked to. Asking for help not only solves the problem at hand, but increases trust, transparency, and builds relationships. Reach out to your healthcare provider, friends, family, and counselors. Remember, help comes to those who ask for it.

Ask your doctor for a simple technique to help you address beliefs and other concerns that sometimes go unnoticed. For example, can you create a daily morning and evening routine that aligns with your prescription? This would help you never forget your medicines.

Patient compliance is like a seat-belt. You wear it all the time even if never intend to get into an accident. Ask for support when you need it, and you should be on your way to recovery.

Thanks for reading, watch this video on how to prepare for doctor visit to get maximum benefit:

References:

https://www.pillsy.com/hubfs/4481181/Pillsy_May2018/images/articles/medication-adherence-infographic-pillsy.png

https://www.ncbi.nlm.nih.gov/pubmed/23417905

https://timesofindia.indiatimes.com/city/mumbai/superbugs-get-tough-25-patients-in-mumbai-resistant-to-strong-antibiotics/articleshow/72091872.cms

Image by Steve Buissinne from Pixabay

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