Compliance in medicine is the need for the patient to play an active part in his or her own recovery from an illness. Patients that do not follow a specified treatment plan are considered non-compliant. In order for a patient to achieve good health, it is important for the patient to follow the guidelines set down by medical practitioners. Non compliance can come in many forms from refusing to take medicine to the lack of understanding of the patient’s condition and the long lasting effects this may have on their health.
In order to improve the situation it’s important to look at why people find it difficult to follow medical advice and to find out ways of improving the situation. Compliance can be seen as one of the most important factors regarding a patient’s recovery from an illness to achieve this it is important to gain an insight to the problems that are faced from a psychological point of view. A good example of this can be found as a result of studies made by Sarafino (1994). He explored the prospect regarding how much people adhere to medical treatment proscribed to them by health care workers.
He found that most people customise their treatment to fit around their own lifestyles. If the patients conforming to the treatment could have a negative change on the person’s lifestyle they are more likely not to conform. He found that people only adhere to 78% of short-term treatments and 54% for chronic conditions. A reason for this is that patients may feel that the illness in which they are suffering from really is not that bad or maybe the medical practitioner has a lack of knowledge regarding the illness or may have got the diagnosis wrong.
In some cases it is possible for the person to become comfortable with the level of their illness or even to have conditioned themselves to cope with the pain in which they may be suffering from. Sarafino also recognised that patients often felt that the medical treatment which they were receiving was having little or no effect on their long term health, this can be put down to the treatment not working as fast as the patient had expected.
Although some people may be worried about the more simple unpleasant side effects of drugs and even the needles that in some cases are used to administer the drugs, this can be a massive hurdle for patients to over come. The Doctors and nurses being confident in their knowledge can rectify this, also, being friendly and approachable will have a positive effect by making the patient feeling more comfortable to be spoken to and allowed to administer the treatment with out complications.
By making surgery’s a less threatening environment, and removing visual barriers, for example a desk in-between the professional and the patient, would make the service user feel more at ease. With the use of softer decoration and a not so sterile look would make the surgery a more comfortable, pleasant and welcoming place to receive treatment in. The Patient may feel more willing to listen and understand what is being discussed with them because it is less threatening.
There are also the more practical problems of treatments such as the cost of prescriptions or getting to the hospital or surgery, some families or older people may find this difficult to afford. Or just find it hard to fit appointments into their busy lifestyles. While other psychologists such as (Baret et al 2001) found that people don’t like to take anymore then 3 drugs at a time without a better understanding of the drug. These issues can leave us with major problems as health care workers.
If people do not take medical treatment as required this can cause implications on the health service itself. For instance if a person refused to have a flu jab, and three months down the line contracted flu which later turned in to phenomena. This could result in a lengthy stay in hospital to recover, this also can be a drain on the health service resources and with risks to the persons long-term health. There is also a darker side to non-compliance this can be seen in mental health wards when for instance patients that suffer from schizophrenia or personality disorder.
Sufferers can become dangerous if medication is not used regularly, We are then forced to rely on the use of sections, which can come into play if medication is not being taken, forcing the person to be of unfit mind. This gives the doctors the legal right to detain mental health suffers under the mental health act of 1983. If the patient is seen to be a risk to themselves or others and the need to administer SSR drugs or anti psychotic medication is present to cause the patient to become under control.
But after the person is discharged within weeks it is often possible for the person to be re-admitted into hospital for the same reason of not taking their medication. This can result in the person relying on the crisis team to administer the drugs by shear force in some cases. After the patient is later discharged into the community the problems usually arise due to the lack of continuation of medication or supervision. In order for compliance to be measured and improved there are various methods we can follow to ensure patients are complying.
An obvious method for this will be taking blood samples from the patient to determine whether or not the medication is found within the blood stream. This can give the Doctor’s a good idea weather or not the person is taking the medication prescribed. Other methods can consist of asking the person how they are getting on with the treatment, if the person is finding it hard to follow the treatment plan the Doctor can adjust the treatment accordingly.
Also counting drugs to see if they are being consumed, and not being flushed down the toilet, this too can be effective. Although medical workers have the tendency to over complicate consultations this can be greatly improved by simplifying the structure of appointments and bringing down the information level to that of the patient making it easier to understand. Ley (1989) found that key points of information could increase the level of compliance.
Which include peoples ability to remember the first and last part of information given to them alongside with repetition and simplified information aimed at the person combined with follow up consultations will greatly improve the chance of a full recovery. To complement the research other investigation’s carried out by Lay and Morris (1984) have found that the effect of written information on medication has found to increased knowledge in 90% of studies, and increase unto 60% in compliance.
This proves that if the time is taken to go through care plans and supply patients with supportive information patients will be far more equipped in the long term with positive information to enable them to make a full recovery. In conclusion, to make treatments more successful simple rules can be followed. Keeping information to a low intellectual format that makes it easier for the patient to follow and adhere to. The medical practitioner should increase the communication regarding medication and the benefits this will have on their health, and by emphasising the importance of completing the treatment.
Ensuring that the patient understands what the side effects of the drugs are, and the level to which the drugs will work, so that the patients understanding of the drug does not exceed expectations. Alongside with enhanced bedside manner this will inset confidence within the patient resulting in a better relationship between them and the health care worker. Once the patient has a better knowledge of what is expected of them, they will have a better understanding of the treatment and will feel happier implicating this into their lifestyle, therefore being compliant.