Compliance is a term that describes the person’s adherence to medical advice. In case of drug therapy when actual dosing history corresponds with prescribed drug regimen it is referred to as compliance which is essential for achieving required therapeutic goals of treatment.
Patient’s noncompliance can interrupt therapeutic goals in many ways. It can reinforce patients into unnecessary diagnostic and treatment procedures by neutralizing the beneficial, preventive and curative services provided. It also leads to higher morbidity and mortality varying wide range of illnesses and also may increases health care cost. Therefore, there is a need of measuring compliance and persistence separately to comprehensively define medication taking behavior.
Various factors have been found to contribute to non-compliance. The main variable was found to be “forgetfulness”, other variables may include; Complexity of drug prescribed, long duration of treatment or psychological factors like lack of believe and negative attitude towards medication. Research data also shows that drug non-compliance could also result from adverse reaction from a particular drug regimen and irregular life style. Variables like social class, number of people, marital status, sex and age are found to be poor indicators of compliance. The relationship of doctors with patients is considered to be an important variable in compliance because poor communication can make elderly patients unable to follow sets of complex instructions. Improved compliance is associated with doctor’s responsiveness and satisfaction. Moreover, it is difficult to assess this type of interaction and to measure its components. So, Unresolved concerns of patient may also contribute to non-compliance including diagnosis, time duration of drug, presence of symptoms and adverse effects. It is believed that patients are primary actor in medical decision making and health professionals should provide appropriate knowledge about diagnosis and therapeutic standards.
Compliance enhancing strategies may include a powerful role by pharmacist for improving adherence. This can be done by improving patient’s information level regarding their regimen with discussion and to emphasize the importance of therapeutic goals. Pharmacist can take considerable steps to decrease the cost of regimen, duration and complexity and educating patients to self-manage their conditions. Moreover, through free flow of knowledge by reorganizing health system and continuing patient’s monitoring towards compliance of treatment. Pharmacists can help use practical aids including reminders and organizers such as dosage counters, blister packs, calendars, special containers and controlled delivery. Information provided by pharmacists about labeling may also help. Many studies show that one-to-one communication and good counseling have positive impact. Whereas written information decreases errors of medication utilization and increases knowledge but has no influence on compliance. This concluded that educational strategies along with behavioral strategies enhances patient’s compliance. Patient’s perception over his illness is also very significant. He should be aware of liability and susceptibility of disease through which they are going on. They should consider the fact that the severity of disease may be reduced by following particular set of recommendation regarding health. Ignorance of important issues is another obstacle to patient’s compliance. Such as disease nature and treatment outcomes which is being given.
It is evident that the compliance is a broader term which cannot be simply taken for granted. For health professionals compliance should be priority for patients especially with chronic disease. So that there could be control of medical emergencies, preventing adverse symptoms and balancing financial comfort. Research about compliance should now be made taking into consideration the reasons and motivation for regimen taking behavior of patient rather than the health care professional’s expectation and perception.
Dr Saima Asif