Compliance

Compliance refers to compliance with certain requirements of different definitions. A good relationship between the parties involved is a basic requirement for positive implementation in everyday life with an impact on behavior and the future. The paternalistic relationship between doctor and patient is therefore being replaced in modern curricula and textbooks by modern behavioral methods.

What is compliance

In medicine, the term compliance is used in relation to the cooperative behavior of the patient in connection with the prescribed therapy. This means that it can also be defined as “therapy adherence” in the medical field. This is particularly important for chronically ill people with regard to taking medication, but also when adhering to prescribed diets or the recommended changes in certain lifestyles.

Compliance is divided into five areas (dimensions):

• Socio-economic factors (level of education / poverty)

• Patient-dependent factors (forgetfulness / knowledge / ability to organize themselves)

• Disease-related factors (symptoms / perceived benefit / concurrent depression)

• Therapy-related factors (side effects / complexity of administration)

• Health system and therapist dependent factors (reimbursement of costs / treatment options / communication)

Patients who are certified as having good compliance consistently follow medical advice. Non-compliance is attested to patients who do not follow / comply with medical advice and therapeutic advice.

Function & task

Positive compliance behavior is based on a good doctor-patient relationship. Within this important relationship, communication should be in a language that the patient can understand. Unfortunately, even today the paternalistic relationship between doctor and patient, which is supported by medical authority, is practiced by some doctors. In modern medical training, this behavior is counteracted in favor of open and understandable language through appropriate textbooks and curricula.

The comprehensible communication between doctor and patient, but also between therapist or pharmacist and patient, does not only contain information about the diagnosis or the underlying disease for an optimized compliance behavior. Rather, it is about the meaning and purpose of the prescribed therapy and the prescribed medication with the prospect of a better quality of life through improved health. In addition, an open relationship with the patient promotes his or her ability to organize himself.

Another great advantage is that any existing risks for non-compliance behavior can be quickly identified by the specialists. These include relapses (relapse of an illness) and signs of forgetfulness.

A good example is the medication box. It is easier for patients to maintain an overview, do not feel overwhelmed so easily and feel involved in the treatment as a thinking person. You enjoy the feeling of being able to exert a positive influence. And precisely this is an almost invaluable advantage for patient compliance behavior. Compliance behavior is also characterized by openness in the context of therapeutic measures.

Questions like “Why do I have to do this? Why should I go to this therapy every day? How long do I have to carry out the therapy? ”Are openly discussed and explained in an understandable way so that the patient recognizes the purpose and is actively involved.

Reliable compliance, even by people who no longer think in different ways and can only structure themselves to a limited extent, is implemented with tools within the framework of functioning compliance. These include above all:

• Attention from doctors and nurses
• A constant exchange of information
• Offers of simplification methods such as (electronic) calendars, tablet boxes and

Compliance reminder systems

• Learning about monitoring methods such as self-measurement of blood pressure and blood sugar or the administration of insulin and independent weight control
• MEMS (electronically measured tablet withdrawal at home)

Illnesses & ailments

Non-compliance, non-compliance with medical advice and non-fulfillment of therapeutically necessary duties, is divided into an intended and an unintentional course of action. First of all, it should be noted that the unintended form is far more common and is mainly due to the forgetfulness of the patient. Further reasons for non-compliant behavior to medical recommendations are:

• The fear of the side effects, which are too massive for many
• Stress from different causes
• An uncomfortable way of taking medication
• Therapy and / or medication costs too high
• The symptoms subsiding (feeling good again)

Further factors for negative behavior can be:

• Insufficient information about your own illness
• Lack of understanding of the consequences
• Insufficient knowledge of the effects of the prescribed medication
• Other ethical attitudes (e.g. religious prohibition of blood transfusion)

Factors based on patient insight, such as reducing obesity, stopping tobacco consumption or integrating more exercise into everyday life, are also triggers for non-compliance behavior. In this regard, patients often lack insight, the will to break down barriers, and the willingness to take advice from professionals.

Depending on the underlying disease, further symptoms, a lower quality of life and an increased risk of death can occur. A direct relationship has been demonstrated between mortality (death rate) and the reliable use of statins and beta blockers in patients who have suffered a heart attack. Further symptoms of the disease and a lower life expectancy are the result, together with unnecessary treatments and an often not inconsiderable increase in costs, also through additional hospital stays.