Reasons for Patient Noncompliance With Treatment

Patient noncompliance. Getty Images Credit: Paul Bradbury

Do you find it hard to follow through with treatment for a disease or condition? Noncompliance and non-adherence are terms doctors use when patients don't adhere to their treatment recommendations and directions.

When patients don't follow through with the treatment decisions they have made together with their physicians, it can cause additional problems. They may not get over their sickness or injury. They may get even sicker or injure themselves further — or worse.

Reasons Patients Don't Comply 

Experts agree on these main reasons patients do not adhere to treatment plans (non-compliance or non-adherence):

  • Denial of the problem. Many diseases and conditions are easy to ignore, even when they have been diagnosed. This is particularly true for diseases that are asymptomatic, meaning they don't have noticeable symptoms that bother the patient. For example, patients with diabetes, or hypertension (high blood pressure) may not have symptoms that get in the way of everyday life. You may not even have known you had the condition until it showed up on a routine examination. That makes it easy for patients to ignore the prescribed treatment regimens. Non-compliance can, of course, have dire consequences.
  • The cost of the treatment. Your medications and therapies may or may not be covered by insurance, and the more out-of-pocket cost to the patient, the less you are likely to adhere to buying the drugs or making treatment appointments.
  • The difficulty of the regimen. Patients may have trouble following the directions. For example, taking a pill in the middle of the night, or simply opening the "child safe" container may create a barrier to compliance.
  • The unpleasant outcomes or side-effects of the treatment. Any perceived negative such as an unpleasant taste of a medicine, the prick of a needle, or the pain of physical therapy may keep the patient from following through.
  • Lack of trust. When patients don't buy into the possibilities of success, they are less likely to follow through. In this case, you don't trust that adherence to the treatment will really improve your health. You aren't convinced that it can make you better.
  • Apathy. When you don't realize the importance of the treatment, or you don't care if the treatment works or not, you are less likely to comply.
  • Previous experience. Especially in the cases of chronic or repeat conditions, patients will sometimes decide that a treatment didn't work in the past, so they are either reluctant or unwilling to try it again.

There are additional reasons patients don't comply; regardless, when a treatment decision has been reached collaboratively, then patients need to follow through with those decisions.

Talk to Your Doctor If You Find It Difficult to Adhere to Treatment

If you find yourself tempted not to follow through on your treatment, then contact your doctor to share your reasons, and together, to the extent it's possible, work out an alternative you both can agree on.

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