Compliance Failure

Patients have beliefs about their illnesses and the need to take medicines. They also have concerns about the effect that taking medicines will have on them. If beliefs are consistent with taking the medicine, compliance and persistence will be better. If taking the medicine makes no real sense to the patient, compliance and persistence will be worse.

Many different factors are at work. Forgetfulness, confusion, misunderstandings and lack of information, denial about an asymptomatic condition, side effects, social issues, inconvenience, and financial constraints can all hinder compliance & persistence.

Programme design should begin with an identification of the key barriers to compliance, which will be influenced by many factors include the nature of the condition (chronic or acute, unpleasant symptoms or largely symptom-free, potentially embarrassing), the drug (side effect profile, dosing schedule, duration of treatment), and the patient population (elderly, young, frail, etc). Only then can the appropriate support package be developed, ensuring that the right mix of support is delivered in the most effective way.