Doctors and nurses spend much of their working fine discussing and assessing patients healthcare problems and recommending actions which will help restore or maintain health. On the basis of these consultations, healthcare professionals (HCP) may recommend taking medication at set times. Keeping clinical appointments, attending physiotherapy, taking prescribed exercise or avoiding health risk behaviours such as unhealthy eating, unsafe sex or smoking. But approximately 50% of patients do not take prescribed treatments as recommended and, across the various recommendations made by HCP's anything from 15% to 93% of patients do not act on recommendations.
In terms of health, adherence(also known as compliance) describes the degree to which a Patient correctly follows medical advice. Most commonly, it refers to medication or drug compliance, but it can also apply to other situations such as medical device use. Self care, self directed exercises or therapy sessions. Non adherence therefew refers to when a patient fails to correctly follow advice
Reasons for non adherence
There are a number of explanations for why people so not stick to their prescribed medical regime, but these can be devised into two types: intentional and non intentional. Non-intentional reasons include confusion and forgetfulness. People can forget intake the occasional dose or they may forget to go to the soviets to renew their prescription. Depending on the nature of the medicine prescribed. Not tracking the whole course can be unimportant d the patient is feeling better, or it can be serious.
Intentional non adherence can be for a number of reasons, from the unpleasant taste to lack of faith in the nature of the medicine. Anything that is intentional is a act that has been consciously decided upon by a reasoning process (cognitive). In other words the patient will have carried out a cost-benefit analysis and come to a conclusion that either it is in their interest to adhere to the medical regime or not. Any such reasoned decision is suggested to be rational, but doctors may not regard it as rational as their perspective is different.
Rational non adherence is therefore an explanation for non adherence which is intentional- a conscious decision is made not to comply to medical advice. It is a cognitive explanation which involves a cost- benefit analysis on the part of the patient. Who then actively weighs up their perceptions of the pros and coma of compiling with the medical advice they have been given.
Factors such as time required, side effectsc or no immediate improvement in their health could be examples of costs which patients decide are greater than any expected benefits. Short term costs can often outweigh long term benefits in the mind of the patients (Link to HBM)
Anecdotal example: if you are taking anti biotics which make you for sick for a week when symptoms have already vanished- costs higher than benefits-severity is lowered so you stop when the costs outweigh benefits
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