Working with the Non-Compliant Patient
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Working with the Non-Compliant Patient

The very word “non-compliant” has a negative connotation to it and sounds like this individual should be punished for something he or she did or did not do. Actually, non-compliance is an older term and is no longer used by some healthcare professionals. Newer terms in its place are “non-adherent”, and “patient choice”. These words sound a little less militarized and lighter in meaning.

Regardless of what the behavior is called, many healthcare professionals feel frustration when patients do not follow up on their advice, treatments or return visits. Even when a person is dealing with a very serious, chronic illness, he or she may still be non-compliant. As a matter of fact, the number one complaint of physicians is that their patients do not follow their advice or follow up on treatment recommendations. Another staggering fact is that over 125,000 people die each year because of medication non-compliance.

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Non-Compliant Behavior

This type of behavior interferes with the effectiveness of treatments for a variety of medical conditions and can lead to serious consequences, including death. It involves a lack of willingness to follow medical advice or doctor’s orders. It can involve the individual’s unwillingness to give up their own power and control. Some people simply do not feel responsible for their own health care. It is deviant, irrational, uncooperative and problematic behavior. Bottom line – it’s not healthy.

What Causes People to be Non-Compliant with Medical Care?

Who would take the time to schedule a doctor’s appointment, get there, go through the motions and then not follow orders? Why even bother, right? There are actually lots of reasons why people are non-compliant. A common one is misunderstanding between the healthcare professional and the patient due to medical terminology, language barriers, hearing disabilities or mental problems. Some people simply do not recognize the seriousness of their condition and don’t believe that follow-up is necessary. Others, due to a lack of insurance or money, are unable to afford the medications, tests or treatments being recommended. Other common reasons for non-compliance include forgetfulness, avoiding unwanted side effects of medications or treatments, feel they don’t need to take the medications prescribed, or believe that the meds simply will not work anyway. Some medications are difficult to take because of their size, the number of meds needed on a daily basis, the regiment is too complex, or they just don’t trust the doctor.

Working Towards Compliance

In an effort to reduce or eliminate non-compliance, healthcare professionals can take just a little bit more time with their patients, form better, trusting relationships and provide more information about the seriousness of the condition and the need to be compliant. That being said, not all patients need extra time with their doctors. As a matter of fact, some experts say that time is not the issue. Instead, motivating the patient to be compliant is the key to self-care.

Motivating patients to be compliant takes good communication skills to influence their beliefs that treatment can be helpful. Active listening is also an important tool to use when trying to motivate a patient to engage in self-care and follow up on doctor’s orders. Explore their views, concerns, and fears about treatment. What are they worried about? If their healthcare provider wants them to quit smoking, what is their biggest concern? Weight gain? While time is a factor, exploring and sharing feelings and emotions during that time is what is most important.

Final Words on Working with the Non-Compliant Patients

Are you always compliant with your doctor’s orders? Do you take every last antibiotic prescribed for an infection even though it gives you stomach upset? Or, do you take enough of the prescription until you feel better and then stop? Follow-up and self-care are obviously very important when it comes to treating any illness or disorder. It is critical to follow your doctor’s orders. Who will provide more care in your life – the doctor or you?

(NOTE: Interested in Nursing CEUs? Checkout my Nursing CEUs on CEU Academy and try a FREE CEU today!)

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