SHN169 – Compliance and Concordance
The Problem with Patient Compliance
Introduction
The issue surrounding patient compliance is itself the term compliance
It is not a term that should be used by health professionals in the 21 st century
What is Compliance?
“The extent to which the patient’s behaviour coincides with medical or health
advice.” (Haynes et al., 1979 cited in Ogden 2007)
Problems with non-compliance
Expensive drugs are dispensed but not used
Expensive appointment times are not utilised
Drug therapies are discontinued too early or self-administered incorrectly
Patients may deceive health professionals about compliance resulting in professional
prescribing less effective treatment or intervention instead
Continued or increased morbidity and mortality
Psychology studies show that patient compliance could be poor – e.g. taking
medicines at the correct time in the correct amount
Compliance Rates Vary
Chemotherapy Good
Pharmaceutics Moderate
Lifestyle choices (diet, smoking etc.) Poor
Ley’s Cognitive hypothesis model of Compliance (1989)
Essentially it is way the medical instruction is given which has a fundamental affect
on whether they are followed or not. It is simply not enough to give instructions but
it is also vital to explain in a way in which the patient can understand
Recall of Information
Many factors hinder effective memory encoding and decoding cognitions: e.g.:
o Existing patient knowledge/understanding
o Inadequate/incomplete explanations
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The Problem with Patient Compliance
Introduction
The issue surrounding patient compliance is itself the term compliance
It is not a term that should be used by health professionals in the 21 st century
What is Compliance?
“The extent to which the patient’s behaviour coincides with medical or health
advice.” (Haynes et al., 1979 cited in Ogden 2007)
Problems with non-compliance
Expensive drugs are dispensed but not used
Expensive appointment times are not utilised
Drug therapies are discontinued too early or self-administered incorrectly
Patients may deceive health professionals about compliance resulting in professional
prescribing less effective treatment or intervention instead
Continued or increased morbidity and mortality
Psychology studies show that patient compliance could be poor – e.g. taking
medicines at the correct time in the correct amount
Compliance Rates Vary
Chemotherapy Good
Pharmaceutics Moderate
Lifestyle choices (diet, smoking etc.) Poor
Ley’s Cognitive hypothesis model of Compliance (1989)
Essentially it is way the medical instruction is given which has a fundamental affect
on whether they are followed or not. It is simply not enough to give instructions but
it is also vital to explain in a way in which the patient can understand
Recall of Information
Many factors hinder effective memory encoding and decoding cognitions: e.g.:
o Existing patient knowledge/understanding
o Inadequate/incomplete explanations
1
