Compliance & Non-Compliance Compliance is a medical term that means the degree to which a patient correctly follows medical advice. It usually refers to taking medication, but may also mean use of medical appliances such as compression stockings, chronic wound care, self-directed physiotherapy exercises, or attending counselling or other courses of therapy.

Non-Compliance: Why do some people not take their medication? Forgetfulness: An elderly gentleman forgets to take his medication because he has memory problems due to the onset of dementia. He sometimes take the medication twice in the same day because he can’t remember if he’s taken it or not. A mum with twin boys forgets to take her medication because her life is so hectic looking after her babies and working part time. A teenage girl forgets to take her contraceptive pill most mornings because she is dyslexic which affects short term memory.

Think of three scenarios each for the following reasons for non-compliance Poor rapport with physician Few symptoms Chronic illness Prescription not collected or not dispensed Purpose of treatment not clear Perceived lack of effect Real or perceived side-effects Instructions for administration not clear Physical difficulty in complying (e.g. opening medicine containers, handling small tablets, swallowing difficulties, travel to place of treatment) Unattractive formulation, such as unpleasant taste Complicated regimen Cost of drugs

Compliance Certain factors increase compliance: 1. Acute Illness (short term) A 7 year old girl has chickenpox. Her older brother already had it and she knows that if she takes the medication, the disease will go in 1 week.

Think of 1 scenario for each of the following reasons that increase compliance: Patient feels ill Limitations of patients activities due to disease state Written instructions for taking medication Simple treatment schedule Short time spent in waiting room Physician recommending one change at a time Benefits of care outweigh costs Peer support