Spotting Noncompliance By Joyce A. Cramer, B.S. Ophthamology Management April 2005

While the article’s focus is ostensibly on adherence to ophthalmologic medications, the principles can be widely applied across many diagnoses and treatments. The prevalence of noncompliance and the problems in recognizing it are discussed with a emphasis on the special difficulty in discovering noncompliance of the sort that occurs when a patient takes her medication erratically or only occasionally.

Common errors in diagnosing noncompliance, such as assuming that well educated patients are less vulnerable to noncompliance and that patients who have a good relationship with the clinician are more likely to be adherent to treatment, are also noted.

Eschewing the equivocation often noted in the clinical literature when considering the topic of compliance measurement, the author declares straightforwardly

The article ends with Ms Cramer planting yet another flag in what has become, justifiably, known as her designated territory – the correlation between simplified medication regimens and higher rates of compliance.

This is an excellent, if not comprehensive, introduction to the challenge the clinician meets on a day in/day out basis in trying to detect and deal with treatment noncompliance.

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