What The Heck Is Compliance?

Compliance is vital to the success of any treatment that your doctor offers you!

So what the heck is compliance? In a nutshell it means following directions exactly. As you read that sentence, I’ll bet you swallowed hard with a bit of a guilty feeling. If you didn’t react like that, let me ask you this – have you always taken all of your medication exactly as prescribed– for the full ten days – two to four times each day for that ten days? How many of you now are hanging your head? Don’t feel badly. Total compliance is very difficult. Many doctors are not even great at being compliant.

It’s a bit easier nowadays to be compliant since you don’t have to take all antibiotics four times a day. Thank goodness for extended release and twice or once a day medications. But even that can be too much for people in this day and age. People are busy and have jobs or kids to pick up and take all over the city. They have very little time to stop and take medications or follow-up treatment (such as physical therapy).

What are some other reasons people don’t comply with instructions? There are many – the easiest one to be corrected is lack of understanding as to why the compliance is important. Most people, once they understand why they need to take their medications in a certain way, will make a greater effort to comply. Often folks will stop taking medications when they feel better no matter what the instructions are. If they know that there is a possibility that their infection will return sooner or their blood pressure may be way out of control if they don’t take the medicine as directed, the chances of increased compliance definitely go up!

But there are other factors that influence this compliance. Doctors can help with this by giving some hints on how to appropriately modify the medication instructions but this only works in some cases. If people feel nauseated when they take their medicine, they will probably stop taking it. Despite what the pharmacy handouts say, you may be able to take the medicine with some crackers or bread to decrease the nausea. But you must ask your doctor (or the staff) if he doesn’t address it when he gives you the prescription. The pharmacist will usually not give you that leeway. Call the doctor’s office and ask. Or, if you’ve had problems with some drugs before, ask the doctor when you get the prescription - while you’re still in his office.

Ask for generics. Expense of medication is a prominent factor in compliance. If you can’t afford the medication, you’ll even consider not picking up the drug. If you ask your doctor to write for generics, you may be able to afford them. You could also consider telling your doctor your situation and asking if there are any samples he could give you.

I think a deterrent in taking drugs is the packaging. Sometimes it’s nearly impossible to open the container. Almost so much of a pain that it’s not worth taking.

Along with this is the size of the pill. You can stick “taste” or “after-taste” in that category too. Some pills are gigantic and many people have difficulty swallowing these pills. It’s also possible that they have a horrible after-taste that keeps people from being diligent in taking them. Again, if the doctor explains this ahead of time (if he knows) but still emphasizes why it’s very important to take them, you may make a greater effort to take them.

Ah, the side-effect trap. Sometimes you’re aware of the potential side effects and sometimes you’re not. Occasionally when you’re aware of what they are, you can tolerate them long enough for your body to get used to the drug (it’s possible that the side effects will diminish (and maybe even leave) after 2-3 weeks. But, if the doctor doesn’t tell you this, you are much more likely to say “to heck with it” and stop taking them. The bad thing though is that the doctor doesn’t know you’ve stopped taking them. If you really feel these side effects make it impossible for you to take it, call the doctor’s office and talk with them and explain what you’re about to do. There may be another drug they can give you. More importantly, there are some drugs that cannot just be stopped all of a sudden. To do this can have dangerous complications. These drugs need to be tapered, not just stopped. You won’t know this unless you call them.

There are other reasons for non-compliance but there are ways around them. Work with the doctor right up front. Tell him about the possible interferences with your taking the medicines the way they are prescribed. Ask what you’re being given and how you’re supposed to take it and if you can identify a problem at that time, let the doctor and find out if there is another drug or another method of dealing with the problem.