Treatment compliance

Treatment compliance is defined as following the recommendations made by a health care provider for a particular medication or other treatment. According to a study reported by the National Council on Patient Information and Education, there is a 76 percent discrepancy between the medications people are prescribed (both prescription and nonprescription drugs) and those they actually take. Most discrepancies are related to people taking medications or dosages other than those originally prescribed.


Compliance barriers
There are a number of barriers to treatment compliance -- events, beliefs or circumstances that impede your ability to comply with treatment recommendations. For example, lack of motivation, resources, knowledge or health management assistance are all potential barriers. A negative treatment experience and inconvenient treatment may also make you less likely to comply with a treatment plan.
Lack of motivation: Some people have doubts about a treatment's ability to lead to change in their lives. Cultural, ethnic or racial beliefs may also hinder treatment compliance or attitude about treatment.

Lack of resources: Some people may lack transportation or have trouble paying for a particular treatment. Support groups may not be readily accessible. Sometimes, there's a language barrier. If the person doesn't read well, the educational materials may be too complex to understand.

Lack of knowledge: Some people do not understand the condition, treatment recommendation or suggested lifestyle changes. A fear of treatment or even a fear of success also may be a concern. In some cases, information overload on the condition or treatment may be an issue.

Health management concerns: Some people may not have the skills or abilities to appropriately manage their condition or treatment. Forgetfulness, confusion or an impaired thought process may also be barriers. Some people may have faulty logic, such as, "I know not to mix my pills with alcohol, so I stop taking my pills when I'm drinking." Others may mistakenly believe the medication has accomplished what it should and is no longer needed.

Negative treatment experience: Slow or poor response to treatment, unrealistic expectations for treatment, uncomfortable side effects or side effects that last more than three days can contribute to treatment compliance issues. An adverse reaction, knowledge of another person's negative treatment experiences, or the perception that a health care provider lacks confidence in the treatment may also be barriers.

Convenience of use: How often the medication must be taken can be a factor. Some people are more likely to follow a treatment program that requires just one dose a day, rather than three or four. The method of administration, such as rectal suppositories or injections vs. pills or inhaled medication, can also have an impact on compliance.


Compliance enhancers
Compliance enhancers are events, beliefs or circumstances that encourage you to comply with treatment recommendations. After all, you're more likely to comply with your treatment plan when you have a positive treatment experience and appropriate knowledge, motivation, skills and resources to follow the recommendations.
Be ready to change. Your readiness to change may be influenced by a history of compliance, positive role models, making a compliance contract or agreement, and being involved in the treatment planning. It's helpful to understand the treatment's potential impact on your health and well-being and believe that you're doing it for yourself and your family, rather than for your doctor. Of course, a positive, trusting relationship with your health care provider is also important, as well as family and other social support.

Learn about your treatment. Work with your health care provider to understand your treatment and its goals. Make sure you know how to follow your treatment protocol. If you don't understand the verbal instructions or can't read the written instructions, ask your health care provider for clarification. If language is a barrier, ask for translation services.

Address resource issues. Adequate financial resources including insurance, can enhance compliance. If transportation is an issue, check into public transit or other transportation services. It may also be helpful to join a support group or have a treatment "buddy" for additional support.

A simple treatment regimen, phone follow-ups from your health care provider, and treatment reminders or other tracking methods may also be helpful. Of course, a positive medication experience that includes fast symptom relief and therapeutic effect, little or no side effects, and feeling good in general while on the treatment regime also encourage treatment compliance.


Characteristics
Failing to comply with your treatment plan may cause the physical, psychological or behavioral characteristics of your condition to continue. You also may feel angry, anxious, fearful, irritable or depressed. You may avoid your health care provider. Eventually, you may refuse to follow treatment recommendations.

Coping strategies
Understand the rationale and importance of being committed to your treatment. Get both verbal and written instructions for your treatment, and find ways to incorporate the treatment plan into your daily routine. Set up an effective reminder system (such as arranging a weekvacations, business trips, or other changes in your schedule or environment. In some cases, this may mean refilling your prescription sooner than usual.
Use effective communication skills with your health care provider. You may want to write down your questions ahead of time and take someone with you to the appointments for support. It's also important to get in tune with yourself, monitor how you're feeling and find effective ways to solve barriers to compliance. Identify cues of relapsing to old, noncompliant behaviors and create a plan to manage these behaviors. Finally, set appropriate and realistic goals for yourself.