1. Health

Compliance: Following Through on Treatment Decisions


Updated August 01, 2009

Wise patients know to adhere to treatment recommendations.

Wise patients know to adhere to treatment recommendations.

© Dušan Zidar - Fotolia.com

Consider this metaphor about patient compliance:

Last spring, John was speeding down the highway, lost control of his car, and landed in a ditch. He wasn't hurt, but he totalled his car, and ended up getting a speeding ticket, too.

He checked in with his lawyer. "Stop speeding, John," his lawyer told him. "Or you'll get yourself into even more trouble."

John loved to drive fast. Still, he considered his other options for getting where he needed to go while avoiding more speeding tickets. He could walk, or ride a bicycle, or he could heed his lawyer's advice.

But two months later, in a hurry to get to work, John was speeding in his new car, and slid off the side of the road, wrapping his car around a tree. This time he was hurt, and transported to the hospital. He had totalled a second car. He got another speeding ticket, and a ticket for wreckless driving, too.

John wasn't very good at heeding advice, was he? He didn't comply with his lawyer's recommendation.

Too many patients are a lot like John. They get sick, they visit their doctor, they collaborate with their doctor to determine their best treatment option, and then they ignore the decision.

Ignoring or not following through with a treatment decision is called non-compliance, or non-adherence and it's one of the biggest causes of non-successful medical care.

It's also one of doctors' biggest complaints. Patients collaborate with their doctors to make treatment decisions, but they just don't follow through.

There are a number of reasons for non-adherence, but the bottom line is that not following through with treatment decisions can only create more problems -- just like with John.

Overcoming Adherence Barriers

Most of the barriers to compliance can be overcome when the doctor and patient are in sync with their thoughts. This comes as a result of building trust, and managing expectations on both sides of the equation.

You, the patient, can make this work by asking plenty of questions, doing some background research on your own, taking responsibility for your own decision-making, and explaining what will and won't work to your doctors.

If your doctor recommends you take cod-liver oil every day but you know you can't stand the taste, ask her to recommend an alternative. Or if you've broken a leg and your doctor puts you in a wheelchair, explain to him that your bedroom is upstairs, and ask if he will give you crutches instead.

If you can't afford the drugs you've been prescribed, speak up as soon as you realize that they are too expensive. Your doctor may be able to prescribe a different, less-expensive, even a generic drug.

Following through -- complying -- with the decisions you and your doctor have made together will help you find better outcomes.

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