Patient Compliance: Why Need to Know?

sristy

More or less every physician or community pharmacist get complain from the patients that drug is not working or drug is not properly curing their diseases. So, what may be the problem? Is the drug have not manufactured properly? Or the physician prescribed the wrong medication? Answer is not always the drug is the villain of not having the proper efficacy of the medication; the villain is referred as ‘Patient Compliance’.

The term ‘Patient Compliance’ is well known to the physician and pharmacist; but may not be known to the patients who have to take medication for a long time. It explains the extent to which a patient properly follows the medication order given by the physician.

After giving prescribed medication order to a patient, the crucial aim is to attain certain desired outcomes in the patients troubled. These preferred outcomes are the main objectives in the managing of the diseases. Proper effect of medication might not be achieved, in spite of all the best aim and efforts on the part of the healthcare professionals; if the patients are non-compliant.

Since 1970, patient compliance has become a topic of scientific concern due to the prevalent nature of patient non-compliance with therapy. Not only the patient compliance but also combination of medication with diet, exercise or life style is also included in therapeutic compliance.

The opinion of health care providers about therapeutic compliance is that it is important for two reasons. Initially not having patient compliance has vital role on the desired treatment. Also, noncompliance would increase financial saddle for society.

An example can be in hypertensive patients, poor compliance with medication is the most significant reason for poorly restricted blood pressure which may cause increase in the risk of myocardial infarction, stroke and renal impairment.

According to the National Health and Nutrition Examination Survey on the health of the US population only 31% of blood pressure was controlled in the patient with hypertension between 1999 and 2000.However, patient non-compliance has been linked with excess urgent care visits, hospitalizations and higher treatment costs. Estimation is that about 25% of patient admitted to hospital in Australia, and 33%–69% of in the USA were due to non-compliance with treatment regimens.

Before a patient has to follow a medication order that patient must understand what they are made-up to do. It is very difficult for a patient to have therapeutic compliance if he or she does not know how to read the prescription and how to follow the order of medicine. So, physician must have a good communicative skill to make patient understand about the medication order and how to follow it. If there is any use of clinical devise; as for asthma patient it can be inhaler, it should be the duty of physician or health care professional to educate patient about the use and maintenance of that devise.

The story is not so different in developing countries as well as in Bangladesh. Due to non-compliance to the anti-hypertensive medications, a harmful impact can result on long term treatment. A study on 146 patients taking anti-hypertensive drug revealed that 55.47% patients were compliant and 44.53% were noncompliant. Among them patients having age greater than 60 years are more non-compliant this is almost 56.6%. However, female patients particularly housewives and people live in the town are more compliant to their medication that is almost 65.11%. There is a tendency to the patients having chronic hypertension to be more non compliant to their medication.

When a patent misunderstand the medication instruction, the risk of non-compliance can be very high. A study over 2500 patients’ exhibit that about 42% misunderstood the medication taking instruction, 25% forgot about the schedule and 60% were unable to read and understand the prescription. Undoubtedly when a very large amount of information is presented to patient there will be a tendency to forget most of the information which increases the risk of non-compliance.

Then patient complain about not having the proper outcomes from the treatment or the drug. To ensure proper compliance community pharmacy should be placed so that patient can communicate and share their problems with health care professionals about their medication.  Awareness should be developed among the patients to share their problem and discuss about their betterment. It will be more effective if patient who forget about their schedule or misunderstand the instruction; to bring under monitoring system to avoid non-compliance rather than establish a proper patient compliance.

Farzana Khan Sristy is a pharmacy student, has completed her graduation under the department of Pharmacy, East West University. She has interest on recent development of treatment methods and drugs. She is doing her research on Phytochemical activities. She can be reached at farzana_sristy@yahoo.com

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