Practical issues in medication compliance

Cramer, JA

doi:10.1016/s0041-1345(99)00112-8

Cited by 13 publications

(12 citation statements)

References 6 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…2 Compliance can be complete or partial, erratic or patterned. 3 Noncompliance is usually inadvertent, but can be intentional. Because of the range and number of health behaviors asked of patients, in most cases a patient cannot be described globally as noncompliant.…”

Section: Definitionmentioning

confidence: 99%

“…10,16 Patients tend to tell health providers what they believe providers want to hear. 3 Leading or biased inquiries (eg 'You've been taking your medication as directed, right?') may contribute to this problem.…”

Section: Perform Appropriate Assessmentmentioning

confidence: 99%

“…It should be noted that assessments made by patients of their failure to take medication tend to be accurate, whereas denials of noncompliance are not. 3 Overall, unbiased queries regarding compliance followed by nonjudgmental discussion can provide the best information. Several other methods have been used in assessing patient compliance.…”

Section: Perform Appropriate Assessmentmentioning

confidence: 99%

“…The accuracy of pill counts in monitoring compliance is dependent on the number of doses actually ingested by the patient vs the number of doses removed from the bottle. Measurement of drug concentration in blood and urine has several limitations, 3 particularly with SCT patients who may have gastrointestinal absorption problems secondary to GVHD. Electronic medication monitoring systems can be extremely useful, 3,18 but are rather costly.…”

Section: Perform Appropriate Assessmentmentioning

confidence: 99%

“…Measurement of drug concentration in blood and urine has several limitations, 3 particularly with SCT patients who may have gastrointestinal absorption problems secondary to GVHD. Electronic medication monitoring systems can be extremely useful, 3,18 but are rather costly. However, missed appointments or questionable drug levels can be used as indicators for further compliance assessment.…”

Section: Perform Appropriate Assessmentmentioning

confidence: 99%

See 4 more Smart Citations

Mismanaging the gift of life: noncompliance in the context of adult stem cell transplantation

Bishop

Rodrigue

Wingard

2002

Bone Marrow Transplant

View full text Add to dashboard Cite

Summary:In this paper, we address the issue of noncompliance with medical regimens in adult stem cell transplant patients. We review the definition, prevalence, and consequences of noncompliance and address whether or not we should alter our medical decision-making with regard to stem cell transplantation based on patient noncompliance. We discuss how the health care team should handle noncompliance issues and propose clinical guidelines for stem cell transplant programs to consider regarding evaluation and management of medical compliance. Bone Marrow Transplantation (2002) 29, 875-880. DOI: 10.1038/sj/bmt/1703523 Keywords: compliance; adult; stem cell transplantation; medical decision-making; clinical guidelinesThe ultimate success of a medical therapy is dependent upon patients' ability and willingness to engage in and maintain certain health behaviors. Noncompliance with medical regimens can result in increased morbidity, mortality, unnecessary healthcare costs, and ultimately, loss of life. Given the advances of stem cell transplantation (SCT), now used successfully to treat a variety of once fatal diseases, very little attention has focused on factors that may maintain or maximize the life that is prolonged by this procedure. We are aware of no published studies that describe the compliance behaviors of adult SCT recipients. In this paper we review the definition, prevalence, and consequences of noncompliance and extrapolate from the general medical and solid organ transplantation (SOT) literatures, how these data could relate to post-SCT outcomes. We then pose two key questions. First, should we alter our medical decision-making based on patient noncompliance? Second, how should the health care team handle noncompliance issues? In conclusion, we propose clinical guidelines for SCT programs to consider regarding evaluation and management of medical compliance. Overview of noncompliance DefinitionThe most quoted definition of compliance is probably that of Haynes et al: 1 'the extent to which a person's behavior (in terms of medication, following diets, or executing lifestyle changes) coincides with medical or health advice'. This useful definition encompasses both the range of possible patient behaviors, as well as the degree to which a patient is compliant. Medical regimens include a variety of behaviors, such as taking medication, attending clinical appointments, following exercise and diet plans, abstaining from or limiting substance use, and engaging in preventive health behaviors. Thus, 'noncompliance is the degree to which behavior fails to coincide with medical recommendations in each of these areas'. 2 Compliance can be complete or partial, erratic or patterned. 3 Noncompliance is usually inadvertent, but can be intentional. Because of the range and number of health behaviors asked of patients, in most cases a patient cannot be described globally as noncompliant. Thus, health professionals should distinguish between compliers, partial compliers, and noncompliers, and not assume that patients who a...

show abstract

Section: Definitionmentioning

confidence: 99%