Beyond Compliance, Adherence, & Concordance – Supporting The Patient’s Implementation Of Optimal Treatment

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AlignMap Overview

Beyond Patient Compliance: A No-Nonsense Approach

There is no impending pharmaceutical discovery, surgical innovation, or governmental policy change with greater potential for improving the health of patients and the efficacy of the healthcare system than simply increasing the percentage of treatment plans that patients carry out as prescribed.

An Unsolved Problem

Noncompliance with treatment is a healthcare catastrophe. Because many otherwise effective treatment plans are inadequately implemented or are not implemented at all,1

  • Millions of unnecessary hospital admissions and thousands of preventable deaths (in the US alone) take place every year
  • Innumerable patients suffer needlessly prolonged, severe, or relapsed diseases
  • Healthcare dollars go to waste at an annual rate of $100 – $300 billion (in the US), losses in workplace productivity take an even higher toll, and patients, their families, and their communities endure profound financial, social, and psychological damage
  • Cascading misinformation, mistrust, and inefficiencies impair medical research, corrode the morale of clinicians, and imperil the healthcare system itself

Interventions to improve patient compliance have had little effect. Programs, protocols, and technology targeting compliance have been unimpressive in well controlled research settings and have had even less impact on day-to-day patient care.2 The full utility of current concepts of medical compliance appears to have already been realized, and there is little indication that further refining and tweaking will render them more effective.

A New Approach is a workshop for developing an alternative approach to improving treatment implementation. The initial version of a pragmatic, readily operational procedure has been constructed by identifying effective strategies that offer utility to everyday healthcare practices from the patient compliance research and work in non-medical fields, adapting these ideas to the politics, economics, and ethics affecting contemporary healthcare, and organizing them into a logical and practical process.3 The essential catalyst to this Best Practices paradigm, however, has been the task of bringing the patient, the clinicians, and other stakeholders into alignment with a single, shared objective: to implement the best workable treatment plan for the patient.4 While further formatting, evaluation, and revision is ongoing, it may well be that this step is the key to improving outcomes, saving lives, decreasing costs, and revitalizing healthcare.

  1. The scope & effect of noncompliance is elaborated at
    Noncompliance Fact & Fiction
  2. A discussion of compliance-enhancement theories & tactics is included at
    State Of The Art
  3. This new approach is introduced at
    AlignMap: Fixes For Today & Vision For Tomorrow
  4. Alignment of stakeholders is specifically addressed at
    Part 1: Clinician-Patient Alignment