Noncompliance (non-adherence) to medical recommendations can have a significant impact on a patient’s overall health quality, resulting in decreased opportunities for prevention, delayed diagnosis, and incomplete or ineffective treatment. There may also be significant liability and financial risks to a responsible healthcare professional treating this patient, particularly as patient outcomes increasingly become connected to quality indicators and reimbursement.
Major national economic costs, including additional healthcare expenditures and lost productivity, may also result. It has been reported that more than 40% of patients may not accurately follow medical recommendations. When treatment requires a more complex regimen, a major lifestyle change, or the patient is otherwise asymptomatic, noncompliance has been reported as high as 70%.
Reasons for noncompliance may include the patient misunderstanding instructions, forgetting, or simply ignoring recommendations. Other patients may actually make an informed decision to decline certain treatments. Common manifestations of patient noncompliance include:
Several factors may influence the ability and willingness of patients to comply with medical recommendations. These may include characteristics of the individual patient, the nature and symptomatology of the condition being treated, and the specifics of the treatment regimen.
Different patients will have varying degrees of the ability to process, understand, and make appropriate decisions regarding basic health information and recommendations.
The characteristics of a potential or confirmed medical condition and the treatment regimen can also affect the patient’s ability or motivation to proceed.
There may be many potential causes which contribute to a patient's noncompliance. The importance of recognizing the issue and addressing this with the patient and family may have a significant impact on the clinical outcome and response to any recommended treatment.
In Part 2 of this series, we will discuss specific points of action to both recognize this problem and measures which may help to further benefit patients’ understanding and acceptance of treatment recommendations.
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