The How To Fix Patient Compliance Now Series
This is the second in a series of posts offering steps to improve the study of and communication about patient compliance.
These recommendations are simple and inexpensive; their implementation, in fact, is solely a function of motivation on the part of those working in the field.
Finally, the benefits of these recommendations are magnificently self-apparent.
These traits are demonstrated by the first step, which was discussed in the previous post, How To Fix Patient Compliance Now – Practical Steps To Rehabilitate The Concept Of Adherence:
1. Always provide context-pertinent definitions of Patient Compliance terminology
Step #1 is, again, simple, inexpensive, and obviously beneficial. After all, since there are no standard, universally applicable definitions of the most basic terms, including “compliance” and “adherence,” it seems clear that using those words in professional literature or commercial promotions obligates the author to provide definitions.
Step #2. Differentiate between unintentional and intentional noncompliance
One can slice and dice noncompliance in a myriad of ways (e.g., according to the type of treatment with which a patient is noncompliant, whether the patient is completely or partially noncompliant, the cause of the noncompliance, etc.). Depending on the situation, certain classifications will be useful or even vital.
In any clinical discussion of noncompliance, however, it is always essential to identify whether noncompliance is intentional or unintentional. (The exceptions are cases in which noncompliance is discussed exclusively as a global concept rather than a clinical event)
If both intentional and unintentional noncompliance are present, those groups must be broken out and described separately.
It’s essential to differentiate between unintentional and intentional noncompliance because intentional and unintentional compliance are fundamentally different events – much as, say, a death due to murder committed for hire by a mob hit man is different from a death caused by pancreatic cancer.
Drawing conclusions, comparing results, or developing patient care methodologies is a hopeless task if unintentional and intentional noncompliance cannot be specifically identified.
Of course, there may be instances in which information distinguishing between intentional and unintentional noncompliance is not available (e.g., reporting on a study that didn’t include that parameter). Happily, there is an simple solution. Studies in which unintentional and intentional noncompliance cannot be differentiated are simply eliminated from consideration.