What Is Patient Compliance in Healthcare?

Compliance applies in many ways to healthcare; in addition to the more common areas many provider organizations think about, like annual training efforts toward compliance with regulations, typically driven by a compliance officer, another significant area of concern is patient compliance.

What Is Patient Compliance in Healthcare?
When the healthcare industry talks about patient compliance, it refers to the myriad behaviors patients may pursue at the direction of a healthcare professional. These may involve medication, lifestyle moderation, therapy of any sort, or diagnostic tests. In addition, patient compliance also involves candor and honesty when interacting with a healthcare professional, so that the person caring for the patient has an accurate idea of the patient’s condition and progress.

How Big Is the Patient Noncompliance Problem?
The Journal of the American Osteopathic Association (JAOA) cites research from the World Health Organization  (WHO) showing that “approximately 125,000 people with treatable ailments die each year in the United States because they do not take their medication properly.” Revealing the extent to which patient compliance is a significant challenge, the same report indicates that “10% to 25% of hospital and nursing home admissions result from patient noncompliance[,] about 50% of prescriptions filled for chronic diseases in developed countries are not taken correctly, and as many as 40% of patients do not adhere to their treatment regimens.”

On the basis of a literature review of 95 studies, Patient Engagement HIT adds that “By and large, patient adherence to preventive screenings was low. Fifty-five percent of all patients across the 95 included studies were adherent to their lung cancer screening regimens.” It is likely that racial disparities are involved in these statistics, and these also “could be connected to insurance status. Patients of color are more likely to be uninsured or underinsured and struggle to access preventive screenings. This has been reflected in other analyses of preventive screening access related to breast and colon cancer screenings.”

Examples of Patient Noncompliance
The American Medical Association offers some examples of patient noncompliance, which they also call patient nonadherence. These may include:

• Fear of side effects, whether not they are realistic and really connected to the medication involved.
• Inability to afford medication or treatment, due to the high cost and limited means.
• Lack of understanding, especially that a medication is effective only when taken regularly.
• Too many medications being taken at once can lead to confusion about dosing schedules that are unnecessarily complex.
• Lack of patient symptoms may lead to the erroneous belief that medication is no longer needed.
• Worry about addiction can lead to not taking necessary medication.
• Depression may also prevent patient adherence.

How to Improve Patient Compliance
Fierce Healthcare suggests four ways to improve patient compliance:

• Quantify the severity of the situation –doctors should talk in terms of concrete improvement that can be expected from suggested care action's.
• Help patients determine their barriers to care and join them to identify solutions to them.
• Look for depression and treat it.
• Enlist allied health professionals and technology solutions to assist with patient engagement.

An overall strategy for improving patient compliance should focus on patient engagement. Clinicians need to develop and practice communication skills that encourage trusting relationships. JAOA reminds us that “Changing behaviors and enhancing comprehension is a complex issue, but unraveling the intricacies begins with a strong patient-physician relationship. The patient and physician make treatment decisions together. This relationship requires more than a medical dissertation wherein the patient nods in agreement without knowing what the physician’s information means. Physicians need to first understand how best to empathetically communicate with patients so they clearly understand the treatment plan and what can happen if they do not participate in their own care.”

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