Patient non-compliance within the context of seeking medical care for arthritis

doi:10.1016/0021-9681(73)90066-0

Journal of Chronic Diseases

Volume 26, Issue 11, November 1973, Pages 689-698

Journal of Chronic D...

https://doi.org/10.1016/0021-9681(73)90066-0 Get rights and content

Abstract

The present study reveals that patients who subjectively experience a long wait when coming to see the doctor, particularly those who feel irritated over this situation tend to be poor compliers with regard to taking medications and continuing to come to the doctor as advised. Likewise, those who feel the doctor spends too little time with them, who perceive the doctor to be more businesslike than personal in the treatment relationship or who lack faith in the treatment regimen tend to be poor compliers. Collectively, these findings indicate that compliance is related to the patient's perception of temporal, relational, and treatment factors within the context of seeking medical help. The practical implication of these findings suggests that efforts to reduce prolonged waiting as well as efforts to personalize the treatment relationship and help patients overcome discouragement and pessimism may prove to be worthwhile investments on the part of those treating patients with rheumatoid arthritis. In any case, each of these factors needs further investigation under controlled conditions to more carefully determine their direct effects on compliance when some of the variables mentioned in this study are altered towards securing more compliant behavior.

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Factors associated with adherence to pharmaceutical treatment for rheumatoid arthritis patients: A systematic review
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Citation Excerpt :
Due to the use of a wide variety of adherence measurement methods, data could not be pooled. For the definition of the primary outcome, most studies chose to dichotomize their patients in being adherent or nonadherent [14,16–18,20,23–30]. 4 studies used 80% of the prescribed dosage taken correctly as cutoff for their primary outcome [14,23,24,30] of which 2 studies provided a rationale.
To identify factors associated with adherence to medication for rheumatoid arthritis or undifferentiated inflammatory arthritis using a systematic literature search.
PubMed, PsycINFO, EMbase and CINAHL databases were systematically searched from inception to February 2011. Articles were included if they addressed medication adherence, used a reproducible definition, determinants and its statistical relationship. Methodological quality was assessed using a quality assessment list for observational studies derived from recommendations from Sanderson et al. (2007) [12]. Resulting factors were interpreted using the Health Belief Model (HBM).
18 out of 1479 identified studies fulfilled the inclusion criteria. 64 factors were identified and grouped according to the HBM into demographic and psychosocial characteristics, cues to action and perceived benefits versus perceived barriers. The belief that the medication is necessary and DMARD use prior to the use of anti-TNF had strong evidence for a positive association with adherence. There is limited evidence for positive associations between adherence and race other than White, general cognition, satisfactory contact with the healthcare provider and the provision of adequate information from the healthcare provider. There is limited evidence for negative associations between adherence and having HMO insurance, weekly costs of TNF-I, having a busy lifestyle, receiving contradictory information or delivery of information in an insensitive manner by the rheumatologist. 18 factors were unrelated to adherence.
The strongest relation with adherence is found to be prior use of DMARDs before using anti-TNF and beliefs about the necessity of the medication. Because the last one is modifiable, this provides hope to improve adherence.
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^☆: Supported by Research Grant No. AM 12058-05 (Experimental Program in Rheumatoid Arthritis), National Institute of Health.

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Patient non-compliance within the context of seeking medical care for arthritis☆

Abstract

J Chron Dis

Lancet

Compliance with medical regimens: A review of the literature

Nursing Res

Compliance with medical regimens: A panel study

J Health Soc Behav

Resistance to treatment: Explorations of the patient's sick role

Am J Psychother

Variations in patients' compliance with doctors' advice: An empirical analysis of patterns of communication

Amer J Public Hlth

Communication between physicians and patients in outpatient clinics

Milbank Mem Fund Quart