Anyone who goes to the doctor usually comes out of the consultation with a prescription in hand. Taking the prescribed tablets, observing bed rest or even taking the recommended walk are among the therapeutic measures that are intended to promote recovery and healing of the patient. Adherence to these actions is referred to by the term “compliance.”
Lack of therapeutic compliance in Germany
The English term “compliance,” which means as much as consent or submissiveness, is called “therapy adherence” in German. Correspondingly, there is also the counter term “non-compliance” in medicine, which is used whenever therapy recommendations are not followed. Whether and in what form patients follow their doctor’s recommendations and instructions depends on a variety of factors.
In any case, however, noncompliance causes considerable costs for the health care system: the statutory health insurance funds estimate the annual costs at 5.4 billion euros.
What prevents patients from following their physician’s instructions?
There are numerous factors that hinder compliance: for example, the form and composition of the medication is often to blame; if the prescribed ½ tablet regularly crumbles when it is cut up, the patient easily loses the desire and prefers not to take the tablets. Taking the medication with meals is also a science in itself. All too often, medications are taken with such foods that prevent absorption of the active ingredient.
Some patients are too confused or even too ill to follow the medication regimen correctly. For example, depressed patients are often reported to have difficulty taking their medications regularly.
Virtual nurse
These issues are primarily a matter for the pharmaceutical industry, which must engage in research and development to address intake forms and dosages. Some innovative approaches already exist: for example, the manufacturer of an antibiotic has taken advantage of the fact that many patients today already have a cell phone.
With the prescribed antibiotic, the patient receives separate information about the SMS reminder service that the manufacturer offers together with the doctor and pharmacist. Using a PIN, the patient can contact a server and from then on will receive regular SMS reminders to take their tablets. The “virtual nurse” reminder service ends with the last tablet; the corresponding data have been coded and stored during registration.
A completely different aspect of compliance or non-compliance concerns the communication between doctor and patient. The physician must know his patient’s circumstances precisely in order to be able to tailor the therapy measures individually and specifically to them. To do this, he must listen properly to his patient and encourage him to cooperate. After all, the aim is to prevent therapy measures from not being adhered to because of scheduling difficulties or because the patient was not made sufficiently aware of the necessity of the actions.
Written explanations, brochures and, under certain circumstances, a follow-up conversation, which the physician may conduct by telephone, also help.
Involving life partners and family members is also important: motivation and guidance to follow therapy, especially for lengthy treatments, are often easier to achieve within the family.
Ask your doctor or pharmacist
Compliance, however, also means not simply continuing to take medications after treatment has expired or, worse, taking them the supposed next time without medical advice. The call for communication is two-pronged: the patient should also talk to his or her doctor or pharmacist and not simply swallow any medication from the medicine cabinet. It is also advisable to go through the medicine cabinet regularly and dispose of expired medicines.
Some medicines are very sensitive: opened eye drops, for example, should not be used after 6 weeks because they may be contaminated with bacteria. In addition to communication with the doctor, here comes the dialogue with the pharmacist, who is a competent contact person when cleaning up the medicine cabinet.
