Review Article of American Journal of Public administration
Patient Compliance: Fact or Fiction?
Assistant Professor, Faculty of Pharmacy, World University of Bangladesh
The word ‘compliance’ comes from the Latin word complire, meaning to fill up and hence to complete an action, transaction, or process and to fulfil a promise. In the Oxford English Dictionary, the relevant definition is ‘The acting in accordance with, or the yielding to a desire, request, condition, direction, etc.; a consenting to act in conformity with; an acceding to; practical assent”. Compliance with therapy is simply patients understanding of medication, motivation toward having this medication is a prescribed manner with the belief that the prescriber and prescribed medicine will be beneficial for his well-being. Although this is often the case, in a number of situations, the physician and pharmacist have not provided the patient with adequate instructions or have not presented the instructions in such a manner that the patient understands them. Nothing should be taken for granted regarding the patient’s understanding of how to use medication, and appropriate steps must be taken to provide patients with the information and counseling necessary to use their medications as effectively and as safely as possible. 20% to 30% of new prescriptions are never filled at the pharmacy. Medication is not taken as prescribed 50% of the time. For patients prescribed medications for chronic diseases, after six months, the majority take less medication than prescribed or stop the medication altogether. There are both federal and state laws that make using or sharing prescription drugs illegal. If someone take a pill that was prescribed to someone else or give that pill to another person, not only is it against the law, it’s extremely dangerous.
Abbreviations: Atrial Fibrillation (AF); Administration Timing Simplification Protocol (ATSP) Asthma Insight and Management (AIM); British Medical Journal (BMJ); Coronary Heart Disease (CHD); Cost-Related Nonadherence (CRNA); Directly Observed Treatment (DOT); Empowerment, motivation, and medical adherence (EMMA); Medical Expenditure Panel Survey (MEPS); Health care professional (HCP); Medication Overuse Headache (MOH); Monoamine Oxidase (MAO); Medication Event Monitoring System (MEMS); Short Acting Beta Agonists (SABAs); Patient package inserts (PPIs); Serious Mental Illness (SMI); Selective Serotonin Reuptake Inhibitors (SSRIs);
Keywords: Adherence; Drug Therapy, Non-compliance; Patient; Medication
How to cite this article:
AK MOHIUDDIN. Patient Compliance: Fact or Fiction? American Journal of Public administration, 2019,1:4.
1.Amir M, Feroz Z, Beg AE. A new health care professional-based model for medication adherence. Patient Prefer Adherence. 2018;12:2085-2091. Published 2018 Oct 10. doi:10.2147/PPA.S171989
2.Agabna NM. Patient Medication Adherence. CME, Sudan Journal of Ra-tional Use of Medicine September 2014 – Issue No.9. Available in: http://apps.who.int/medicinedocs/documents/s22198en/s22198en.pdf
3.Al-Foraih M, Somerset S. Factors Affecting Adherence to Statins in Hy-percholesterolemic Kuwaiti Patients: A Cross-Sectional Study. Med Princ Pract. 2016;26(1):35-40.
4.Al-Khaja KA, Sequeira RP, Alkhaja AK, Damanhori AH. Antihypertensive Drugs and Male Sexual Dysfunction: A Review of Adult Hypertension Guideline Recommendations. J Cardiovasc Pharmacol Ther. 2016 May;21(3):233-44. doi: 10.1177/1074248415598321. Epub 2015 Oct 7. Review. PMID: 26450998
5.Al-Mansari A, Obeid Y, Islam N, et al. GOAL study: clinical and non-clinical predictive factors for achieving glycemic control in people with type 2 diabetes in real clinical practice. BMJ Open Diabetes Res Care. 2018;6(1):e000519. Published 2018 Jul 10. doi:10.1136/bmjdrc-2018-000519
6.Baptist Health. Medrol dosepak. Health Library 7/4/2018
Available in: https://www.baptistjax.com/health-library/drug-images/medrol-dosepak
7.Butterworth SW. Influencing patient adherence to treatment guidelines. J Manag Care Pharm. 2008 Jul;14(6 Suppl B):21-4. PMID: 18693785
8.Brown MT, Bussell JK. Medication adherence: WHO cares?. Mayo Clin Proc. 2011;86(4):304-14.
9.Boeni F, Spinatsch E, Suter K, Hersberger KE, Arnet I. Effect of drug re-minder packaging on medication adherence: a systematic review reveal-ing research gaps. Syst Rev. 2014;3:29. Published 2014 Mar 24. doi:10.1186/2046-4053-3-29
10.Bhimji SS, Scherbak Y. Medication Errors. [Updated 2018 Oct 27]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2018 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK519065/
11.Bouvier. Medicine-on-Time. Pharmacy 2012. Available in: http://www.bouvierpharmacy.com/medicine-time
12.Bond WS, Hussar DA. Detection methods and strategies for improving medication
compliance. Am J Hosp Pharm. 1991 Sep;48(9):1978-88. PubMed PMID: 1928147.
13.Bosworth HB, Granger BB, Mendys P, et al. Medication adherence: a call for action. Am Heart J. 2011;162(3):412-24.
14.Braaf S, Ameratunga S, Nunn A, et al. Patient-identified information and communication needs in the context of major trauma. BMC Health Serv Res. 2018;18(1):163. Published 2018 Mar 7. doi:10.1186/s12913-018-2971-7
15.Casciano JP, Dotiwala ZJ, Martin BC, Kwong WJ. The costs of warfarin underuse and nonadherence in patients with atrial fibrillation: a commer-cial insurer perspective. J Manag Care Pharm. 2013 May;19(4):302-16. PMID: 23627576
16.Chia Y. Understanding patient management: the need for medication adherence and persistence. Malays Fam Physician. 2008;3(1):2-6. Pub-lished 2008 Apr 30.
17.Checchi KD, Huybrechts KF, Avorn J, Kesselheim AS. Electronic medica-tion packaging devices and medication adherence: a systematic review. JAMA. 2014;312(12):1237-47.
18.Coleman CI, Limone B, Sobieraj DM, Lee S, Roberts MS, Kaur R, Alam T. Dosing frequency and medication adherence in chronic disease. J Manag Care Pharm. 2012 Sep;18(7):527-39. Review. PMID: 22971206
19.Devine F, Edwards T, Feldman SR. Barriers to treatment: describing them from a different perspective. Patient Prefer Adherence. 2018;12:129-133. Published 2018 Jan 17. doi:10.2147/PPA.S147420
20.Divya S, Nadig P. Factors Contributing To Non-Adherence To Medica-tion Among Type 2 Diabetes Mellitus In Patients Attending Tertiary Care Hospital In South India. Asian J Pharm Clin Res, Vol 8, Issue 2, 2015, 274-276.
21.Evans L, Spelman M. The problem of non-compliance with drug therapy. Drugs.
1983 Jan;25(1):63-76. Review. PubMed PMID: 6337812
22.Erku DA, Ayele AA, Mekuria AB, Belachew SA, Hailemeskel B, Tegegn HG. The impact of pharmacist-led medication therapy management on medication adherence in patients with type 2 diabetes mellitus: a random-ized controlled study. Pharm Pract (Granada). 2017;15(3):1026.
23.En-Vision America®. En-Vision America Introduces the ScripTalk Talking Prescription System. Normal, IL March 20, 2001. Available in: https://www.envisionamerica.com/en-vision-america-introduces-the-scriptalk-talking-prescription-system/
24.Ensing HT, Vervloet M, van Dooren AA, Bouvy ML, Koster ES. Patient-pharmacist communication during a post-discharge pharmacist home vis-it. Int J Clin Pharm. 2018;40(3):712-720.
25.Fatima J, Sadiq SM and others. Patient Medication Adherence and the Health Outcome. Asian J. Pharm. Res. 2018; 8(2):78-82.
26.Fraser S. Concordance, compliance, preference or adherence. Patient Prefer Adherence. 2010;4:95-6.
27.Fisher RC. Patient education and compliance: a pharmacist’s perspec-tive.
Patient Educ Couns. 1992 Jun;19(3):261-71. Review. PubMed PMID: 1300624.
28.Foster T, Milen D. Medication Compliance. American Society for Public Administration Apr 2010.
29.Garvie PA, Lawford J, Flynn PM, et al. Development of a directly observed therapy adherence intervention for adolescents with human immunode-ficiency virus-1: application of focus group methodology to inform design, feasibility, and acceptability. J Adolesc Health. 2008;44(2):124-132.
30.Gerald JK, Carr TF, Wei CY, Holbrook JT, Gerald LB. Albuterol Overuse: A Marker of Psychological Distress?. J Allergy Clin Immunol Pract. 2015;3(6):957-62.
31.González-Hernández A, Marichal-Cancino BA, MaassenVanDenBrink A, Villalón CM. Side effects associated with current and prospective antimi-graine pharmacotherapies. Expert Opin Drug Metab Toxicol. 2018 Jan;14(1):25-41. doi: 10.1080/17425255.2018.1416097. Epub 2017 Dec 15. Review. PMID: 29226741
32.Gupta S, McColl MA, Guilcher SJ, Smith K. Cost-related nonadherence to prescription medications in Canada: a scoping review. Patient Prefer Ad-herence. 2018;12:1699-1715. Published 2018 Sep 6. doi:10.2147/PPA.S170417
33.Hart JE, Jeon CY, Ivers LC, et al. Effect of directly observed therapy for highly active antiretroviral therapy on virologic, immunologic, and adher-ence outcomes: a meta-analysis and systematic review. J Acquir Immune Defic Syndr. 2010;54(2):167-79.
34.Hussar DA, 2006. Chapter 98. Patient Compliance. Remington The Sci-ence and Practice of Pharmacy 21st Edition. Editor: David B. Troy Manag-ing Editor: Matthew J. Hauber, Lippincott Williams & Wilkins 351 West Camden Street Baltimore, Maryland 21201-2436 USA
35.Jafar TH, Gandhi M, Jehan I, Naheed A, de Silva HA and others. CO-BRA-BPS Study Group; Determinants of Uncontrolled Hypertension in Rural Communities in South Asia—Bangladesh, Pakistan, and Sri Lanka, American Journal of Hypertension, Volume 31, Issue 11, 15 Octo-ber 2018, Pages 1205–1214, https://doi.org/10.1093/ajh/hpy071
36.Jimmy B, Jose J. Patient medication adherence: measures in daily prac-tice. Oman Med J. 2011;26(3):155-9.
37.Jin H, Kim Y, Rhie SJ. Factors affecting medication adherence in elderly people. Patient Prefer Adherence. 2016;10:2117-2125. Published 2016 Oct 19. doi:10.2147/PPA.S118121
38.Jung SH, Lee OS, Kim HS, et al. Medication Adherence Improvement By Using Administration Timing Simplification Protocol (ATSP) in Cardio-vascular Disease Patients. J Atheroscler Thromb. 2017;24(8):841-852.
39.Köberlein-Neu J, Mennemann H, Hamacher S, et al. Interprofessional Medication Management in Patients With Multiple Morbidities. Dtsch Arz-tebl Int. 2016;113(44):741-748.
40.Kandler L, Tscholl DW, Kolbe M, Seifert B, Spahn DR, Noethiger CB. Us-ing educational video to enhance protocol adherence for medical proce-dures. Br J Anaesth. 2016 May;116(5):662-9. doi: 10.1093/bja/aew030. PMID: 27106970
41.Kleinsinger F. The Unmet Challenge of Medication Nonadherence. Perm J. 2018;22:18-033.
42.Kennedy J, Erb C. Prescription noncompliance due to cost among adults with disabilities in the United States. Am J Public Health. 2002;92(7):1120-4.
43.Klobusicky JJ, Aryasomayajula A, Marko N. Evolving Patient Compliance Trends: Integrating Clinical, Insurance, and Extrapolated Socioeconomic Data. AMIA Annu Symp Proc. 2015;2015:766-74. Published 2015 Nov 5.
44.Kumar K, Greenfield S, Raza K, Gill P, Stack R. Understanding adher-ence-related beliefs about medicine amongst patients of South Asian origin with diabetes and cardiovascular disease patients: a qualitative synthesis. BMC Endocr Disord. 2016;16(1):24. Published 2016 May 26. doi:10.1186/s12902-016-0103-0
45.Kuo SZ, Haftek M, Lai JC. Factors Associated with Medication Non-adherence in Patients with End-Stage Liver Disease. Dig Dis Sci. 2016;62(2):543-549.
46.Lahon K, Shetty HM, Paramel A, Sharma G. Sexual dysfunction with the use of antidepressants in a tertiary care mental health setting – a retro-spective case series. J Pharmacol Pharmacother. 2011;2(2):128-31.
47.Lardizabal JA, Deedwania PC. Benefits of statin therapy and compliance in high risk cardiovascular patients. Vasc Health Risk Manag. 2010;6:843-53. Published 2010 Oct 5. doi:10.2147/VHRM.S9474
48.Lemay J, Waheedi M, Al-Sharqawi S, Bayoud T. Medication adherence in chronic illness: do beliefs about medications play a role?. Patient Prefer Adherence. 2018;12:1687-1698. Published 2018 Sep 5. doi:10.2147/PPA.S169236
49.Lunenfeld B, Stratton P. The clinical consequences of an ageing world and preventive strategies. Best Pract Res Clin Obstet Gynaecol. 2013;27(5):643-59.
50.Liu J, Xu G, Yang Y, Gao Y. The analysis of classified protection compli-ance detection based on Dempster-Shafer theory. 2010 IEEE Interna-tional Conference on Progress in Informatics and Computing, Shanghai China 10-12 Dec. 2010. DOI: 10.1109/PIC.2010.5687467
51.Lucas GM, Flexner CW, Moore RD. Directly administered antiretroviral therapy
in the treatment of HIV infection: benefit or burden? AIDS Patient Care STDS.
2002 Nov;16(11):527-35. Review. PubMed PMID: 12513901.
52.Manmohan T, Sreenivas G, Sastry VV and others. Drug Compliance And Adherence To Treatment Journal of Evolution of Medical and Dental Sci-ences/Volume1/ Issue3/July-Sept 2012 Page 142-159
53.Marton A. The Benefits of Medication Compliance. The Canadian Mental Health Association (CMHA) December 28, 2018
54.Morgan SG, Lee A. Cost-related non-adherence to prescribed medicines among older adults: a cross-sectional analysis of a survey in 11 devel-oped countries. BMJ Open. 2017;7(1):e014287. Published 2017 Jan 30. doi:10.1136/bmjopen-2016-014287
55.Mazzullo JM. Patient package inserts. Br Med J. 1978;2(6137):586.
56.Mohiuddin Ak . The New Era of Patient Communication and Relationship Management . Adv Nursing Patient Care Int J 2018, 1(2): 18000 8 .
57.MaxiAIDS.com. Medication Aids Talking Rx- Your Personal Talking Pre-scription. Available in: https://www.maxiaids.com/talking-rx-your-personal-talking-prescription
58.Moonan PK, Quitugua TN, Pogoda JM, et al. Does directly observed ther-apy (DOT) reduce drug resistant tuberculosis?. BMC Public Health. 2011;11:19. Published 2011 Jan 7. doi:10.1186/1471-2458-11-19
59.Naheed A, Haldane V, Jafar TH, Chakma N, Legido-Quigley H. Patient pathways and perceptions of hypertension treatment, management, and control in rural Bangladesh: a qualitative study. Patient Prefer Adher-ence. 2018;12:1437-1449. Published 2018 Aug 14. doi:10.2147/PPA.S163385
60.New medical devices. P T. 2014;39(2):83-129.
61.National Research Council (US) Committee on the Role of Human Fac-tors in Home Health Care. The Role of Human Factors in Home Health Care: Workshop Summary. Washington (DC): National Academies Press (US); 2010. 6, The Health Care Challenge: Matching Care to People in Their Home Environments.
62.Ozturk AB, Iliaz S. Challenges in the management of severe allergic asthma in the elderly. J Asthma Allergy. 2016;9:55-63. Published 2016 Mar 17. doi:10.2147/JAA.S85420
63.Pratt M, Searles GE. Using Visual Aids to Enhance Physician-Patient Discussions and Increase Health Literacy. J Cutan Med Surg. 2017 Nov/Dec;21(6):497-501. doi: 10.1177/1203475417715208. Epub 2017 Jun 14. PMID: 28614954
64.Raynor DK, Booth TG, Blenkinsopp A. Effects of computer generated re-minder charts on patients’ compliance with drug regimens. BMJ. 1993;306(6886):1158-61.
65.Reinhard SC, Given B, Petlick NH, et al. Supporting Family Caregivers in Providing Care. In: Hughes RG, editor. Patient Safety and Quality: An Ev-idence-Based Handbook for Nurses. Rockville (MD): Agency for Healthcare Research and Quality (US); 2008 Apr. Chapter 14.
66.Roter DL, Hall JA, Merisca R, Nordstrom B, Cretin D, Svarstad B. Effec-tiveness
of interventions to improve patient compliance: a meta-analysis. Med Care. 1998
Aug;36(8):1138-61. PubMed PMID: 9708588.
67.Sabate E. Chapter 5. Towards the Solution. In: Eduardo Sabate. Adher-ence to Long-term Therapies: Evidence for Action. World Health Organi-zation, 2003
68.Saghaeiannejad-Isfahani S, Ehteshami A, Savari E, Samimi A. Develop-ing the Medication Reminder Mobile Application “Seeb”. Acta Inform Med. 2017;25(2):108-111.
69.Shrivastava SR, Shrivastava PS, Ramasamy J. Role of self-care in man-agement of diabetes mellitus. J Diabetes Metab Disord. 2013;12(1):14. Published 2013 Mar 5. doi:10.1186/2251-6581-12-14
70.Shruthi R, Jyothi R, Pundarikaksha HP, Nagesh GN, Tushar TJ. A Study of Medication Compliance in Geriatric Patients with Chronic Illnesses at a Tertiary Care Hospital. J Clin Diagn Res. 2016;10(12):FC40-FC43.
71.Stefanacci RG, Guerin S. Why Medication Adherence Matters To Pa-tients, Payers, Providers. Managed Care January 29, 2013
72.Suri N and Varkey K. Patient Compliance – The Next Challenge In Health Care Innovation. Healthcare Business Today June 17, 2017
73.Subbaraman R, de Mondesert L, Musiimenta A, et al. Digital adherence technologies for the management of tuberculosis therapy: mapping the landscape and research priorities. BMJ Glob Health. 2018;3(5):e001018. Published 2018 Oct 11. doi:10.1136/bmjgh-2018-001018
74.Shah AJ, Singh V, Patil SP, Gadkari MR, Ramchandani V, Doshi KJ. Factors Affecting Compliance to Antihypertensive Treatment among Adults in a Tertiary Care Hospital in Mumbai. Indian J Community Med. 2018;43(1):53-55.
75.Shroufi A, Powles JW. Adherence and chemoprevention in major cardio-vascular disease: a simulation study of the benefits of additional use of statins. J Epidemiol Community Health. 2010 Feb;64(2):109-13. doi: 10.1136/jech.2009.091033. PMID: 20056964
76.Taitel MS, Mu Y, Gooptu A, Lou Y. Impact of late-to-refill reminder calls on medication adherence in the Medicare Part D population: evaluation of a randomized controlled study. Patient Prefer Adherence. 2017;11:373-379. Published 2017 Feb 28. doi:10.2147/PPA.S127997
77.Usherwood T. Encouraging adherence to long-term medication. Aust Prescr. 2017;40(4):147-150.
78.Varming AR, Hansen UM, Andrésdóttir G, Husted GR, Willaing I. Em-powerment, motivation, and medical adherence (EMMA): the feasibility of a program for patient-centered consultations to support medication ad-herence and blood glucose control in adults with type 2 diabetes. Patient Prefer Adherence. 2015;9:1243-53. Published 2015 Sep 1. doi:10.2147/PPA.S85528
79.Velligan DI, Sajatovic M, Hatch A, Kramata P, Docherty JP. Why do psy-chiatric patients stop antipsychotic medication? A systematic review of reasons for nonadherence to medication in patients with serious mental illness. Patient Prefer Adherence. 2017;11:449-468. Published 2017 Mar 3. doi:10.2147/PPA.S124658
80.Waring J, Marshall F, Bishop S, et al. An ethnographic study of knowledge sharing across the boundaries between care processes, ser-vices and organisations: the contributions to ‘safe’ hospital discharge. Southampton (UK): NIHR Journals Library; 2014 Sep. (Health Services and Delivery Research, No. 2.29.) Chapter 2, Hospital discharge and pa-tient safety: reviews of the literature.
81.WebMD. Side Effects of High Blood Pressure Medications. Hypertension Guide Apr 17, 2017
82.Wu JR, Moser DK, Chung ML, Lennie TA. Predictors of medication ad-herence using a multidimensional adherence model in patients with heart failure. J Card Fail. 2008;14(7):603-14.
83.Wertheimer AI and Wilson JM. Custom Medication Flavoring: Valuable Opportunities to Improve Customer Satisfaction,. Store Loyalty, Patient Compliance and Pharmacy Revenues. Wilson Health Information, LLC, New Hope, PA (2008 – 2012).
Available in: http://www.flavorx.com/pharmacies/files/2014/12/WilsonRx-Flavoring-Research-Report.pdf
84.Wright CM, Westerkamp L, Korver S, Dobler CC. Community-based di-rectly observed therapy (DOT) versus clinic DOT for tuberculosis: a sys-tematic review and meta-analysis of comparative effectiveness. BMC In-fect Dis. 2015;15:210. Published 2015 May 8. doi:10.1186/s12879-015-0945-5
85.Willeboordse F, Hugtenburg JG, Schellevis FG, Elders PJ. Patient partic-ipation in medication reviews is desirable but not evidence-based: a sys-tematic literature review. Br J Clin Pharmacol. 2014;78(6):1201-16.
86.Yu Y, Luo D, Chen X, Huang Z, Wang M, Xiao S. Medication adherence to antiretroviral therapy among newly treated people living with HIV. BMC Public Health. 2018;18(1):825. Published 2018 Jul 4. doi:10.1186/s12889-018-5731-z
87.Zelko E, Klemenc-Ketis Z, Tusek-Bunc K. Medication Adherence in El-derly with Polypharmacy Living At Home: A Systematic Review Of Exist-ing Studies. Mater Sociomed. 2016;28(2):129-32.
88.Zullig LL, Blalock DV, Dougherty S, et al. The new landscape of medica-tion adherence improvement: where population health science meets precision medicine. Patient Prefer Adherence. 2018;12:1225-1230. Pub-lished 2018 Jul 13. doi:10.2147/PPA.S165404