Strategies for enhancing patient compliance

Abstract

Patient noncompliance is a substantial obstacle to the achievement of therapeutic goals. This paper reviews a number of practical interventions with demonstrated efficacy in enhancing patient adherence, including (1) improving patients' levels of information concerning the specifics of their regimens, reinforcing essential points with review, discussion, and written instruction, and emphasizing the importance of the therapeutic plan, (2) taking clinically appropriate steps to reduce the cost, complexity, duration, and amount of behavioral change required by the regimen and increasing the regimen's convenience through "tailoring" and other approaches, (3) obtaining a compliance-oriented history of the patient's prior experiences and present health beliefs and, where necessary, employing strategies to modify those perceptions likely to inhibit compliance, (4) improving levels of patient satisfaction, particularly with the provider-patient relationship, (5) arranging for the continued monitoring of the patient's subsequent compliance to treatment, (6) increasing staff awareness of the magnitude and determinants of the noncompliance phenomenon and attempting to develop an "active influence orientation" in each member of the health care team, (7) using such techniques as patient-provider contracts to involve the patient in therapeutic decisions and in the setting of treatment objectives and creating incentives (through rewards and reinforcements) for achieving these objectives, (8) arranging for as much continuity of provider (and other staff) as possible, (9) establishing methods of supervising the patient, including involvement of the patient's social support network, and (10) involving fully the assistance of all available health care providers, assigning specific roles and responsibilities for activities directed at improving adherence to treatment.

Chronic Osteoarthritis and Adherence to Exercise: A Review of the Literature

“…In addition to this, those who understand why they need to exercise and are knowledgeable about their exercise regimen and its potential effectiveness are more likely to engage in regular exercise than those with limited knowledge and understanding (Becker & Maiman, 1980;Cameron, 1996). Other related exerciseadherence predictors include (a) the quality of the patient-provider relationship and degree of patient satisfaction with the relationship; (b) the extent of social isolation versus social support, including the effect of the family; (c) the individualʼs health beliefs and health attitudes, for example, their perceived barriers to exercising, or perceived degree of helplessness (Resnick & Spellbring, 2000); (d) the presence of depression (Wing, Phelan, & Tate, 2002) and its negative impact on self-effi cacy (Maciejewski, Prigerson, & Mazure, 2000); and (e) the individualʼs skills and capacity for self-regulation (Hallam & Petosa, 2004;Schutzer & Graves, 2004).…”

Myths and beliefs of long-term care providers towards starting inhaled medications in children with bronchial asthma

“…Thus, parents who doubt the efficacy of inhalers and have misconceptions and myths regarding the use of inhalers are less likely to enforce treatment adherence diligently in their child and hence the compliance would be poor in them 8,9 . Therefore, education and counselling of the parents of patients are important in ensuring compliance 10 . In that context, it is important to identify the common myths and beliefs in our parents and their associations with socio-demographic factors.…”

Patient adherence to ischemic heart disease treatment

“…It is unlikely that any intervention that ignores the multidimensionality of problems will succeed in achieving behavior change. 30 …”