Compliance with Doctors’ Instructions

For medical purposes, compliance is defined as the extent to which a patient follows the instructions of a doctor and includes taking medications on schedule, keeping appointments and following directions for changes in lifestyle, such as changing one’s diet or exercise.

Although the cost of obtaining medical advice and medication is one of the largest items in a family budget, many people defeat the health-care process by departing from the doctor’s recommendations. This failure to carry out the doctor’s instructions is the single most common cause of treatment failure. Perhaps the instructions were not presented clearly, or you may not have understood them or realized their importance and benefits.

Factors That Can Cause Problems With Compliance:

• Treatment recommendations that combine two or more actions (such as instructions to take medication, see a therapist and join a support group).

• Recommendations that require lifestyle changes (such as dieting).

• Recommendations that involve long-term treatment (such as taking a medication for life).

• Recommendations for very young patients or for the elderly (when another person has to be responsible for following the instructions).

• Other factors include traveling and time changes, busy work schedules and lack of organization.

Examples of Noncompliance:

• Medications are forgotten or discontinued too soon. Forgetting to take a medication is the most common of all shortcomings, especially if a medication must be taken more than once a day. If you need to take a medication several times a day, set out a week’s supply in an inexpensive pill box that you can carry with you.

• Side effects of medications are a common problem. Almost all medications have some unpleasant side effects. Often these disappear after a few days, but if they don’t, let your doctor know right away. Side effects can often be controlled by changing dosage, switching to a similar medication or by adding medications that control the side effects.

• Not taking a drug because it is unpleasant (e.g., bad tasting). Ask your doctor about options.

• Cost is another reason why there are treatment failures. Because of a tight budget, a person may take a medication less frequently than prescribed or just not purchase it. If you can’t afford a medication, perhaps a less costly one can be prescribed or your doctor can find other ways to provide it.

• Laboratory tests, x-rays or other recommended medical studies are not obtained, perhaps due to concerns about costs or fear of the tests themselves.

• Recommendations about behavioral changes such as diet or exercise are ignored (old habits are difficult for anyone to change).

• Suggested immunizations are not obtained, sometimes due to fear of needles.

• Follow-up visits to the doctor are not made, or appointments are canceled, perhaps due to problems finding transportation or long waiting times in the doctor’s office.

Communicating With Your Doctor:

• If you don’t understand something, ask.

• If there are reasons why you cannot follow a recommendation, speak up.

• If you have reservations or fears about treatment, discuss them.

Remember, it is your health and your money that are at issue. You and your doctor are—or should be—working together to make you well and keep you healthy.