Patient non-compliance: Deviance or reasoned decision-making?

Donovan, Jenny; Blake, David R.

doi:10.1016/0277-9536(92)90206-6

Cited by 680 publications

(485 citation statements)

References 20 publications

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“…This comparison is illustrated in Table 2. The findings of the present study extends previous research by showing that reliance, routine and pill load are further contributors to use of NSAIDs in OA, and impediments to use of paracetamol (17)(18)(19)(20). In this regard, our findings differ from those of Barozzi and Tett who did not find scepticism towards the effectiveness of paracetamol and pill load to be barriers to paracetamol use among consumers (16).…”

Section: Discussionsupporting

confidence: 69%

“…As focused upon in our previous research (21), some patients disliked taking medicines because of fears surrounding toxicity and addiction. This is a common finding in research on analgesia in OA and medicine-taking in general (20,(26)(27)(28)(29). In the present study, regardless of whether they were skeptical about using medicines, patients were reliant upon their NSAID and took it routinely.…”

Section: Discussionmentioning

confidence: 67%

“…Our study provides an explanation for this by demonstrating the power of routine in determining medicine use. The willingness of patients to take CMs despite being sceptical about their effectiveness suggests that patients have very different expectations of CMs compared to non-CMs, much of this relating to the perception that so called 'natural' is 'safe' or 'good' (20).…”

Section: Discussionmentioning

confidence: 99%

“…These studies have shown that patients take an NSAID to comply with advice given by the doctor, but also importantly because pain relief and function are paramount (17)(18)(19)(20). Additionally, patients are unsure as to whether other medicines, such as paracetamol, are more effective or safer than their current NSAID (17).…”

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

“It looks after me”: How older patients make decisions about analgesics for osteoarthritis

Milder¹,

Lipworth²,

Williams³

et al. 2011

Arthritis Care & Research

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Objective: To explore the key motivators behind selection of analgesics (non-steroidal anti-inflammatory drugs (NSAIDs), paracetamol and complementary medications (CMs)) by patients with osteoarthritis (OA).Methods: A qualitative study, in which in-depth semi-structured interviews were conducted with 15 OA patients, recruited from four general practices in Sydney, Australia. Patients were aged 65 or above, and were currently taking, or had recently taken, an NSAID for osteoarthritis.Results: Three key themes emerged from the data: reliance, routine and pill load. Reliance: Patients were strongly reliant upon NSAIDs because they consistently satisfied their needs. By contrast, they were much less reliant upon paracetamol because of uncertainty or scepticism about its effectiveness. They were not reliant upon CMs but were willing to take them indefinitely because they were perceived as being without risk. Routine and pill load: Many patients took an NSAID, as well as CMs as part of a 'daily routine'. By contrast, patients had difficulty developing a routine around using paracetamol at the recommended maximum dose because of the implicit frequency of dosing required and an aversion to the associated 'pill load'. Conclusion:The results highlight the importance of exploring the perceptions and preferences of patients with regard to analgesics for OA. Clinician advice regarding analgesia for OA should take account of the possible reliance of the patient upon an NSAID, their medicine routines, and their potential concern about the pill load associated, in particular, with paracetamol.

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Section: Discussionsupporting

confidence: 69%

Section: Discussionmentioning

confidence: 67%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

“It looks after me”: How older patients make decisions about analgesics for osteoarthritis

Milder¹,

Lipworth²,

Williams³

et al. 2011

Arthritis Care & Research

View full text Add to dashboard Cite

show abstract

“…Noncompliance with medical treatment is not unique to women with high risk pregnancies. Up to half of the general population do not comply fully with recommended treatment regimens so such behaviour cannot be considered a minority or deviant reaction (Donovan and Blake 1992). Women with high risk pregnancies are committed to achieving good outcomes for themselves and their babies so professionals should not regard non-adherence to a treatment programme as evidence of recalcitrance or a lack of care (Durham 1999).…”

Section: Discussionmentioning

confidence: 99%