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Patient Non-Compliance and Shared Decision Making in Medical Field

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If you hang around in healthcare long enough, eventually your paths will cross with a non-compliant patient, which for the record is not the same as non-adherence patient. A non-compliant patient is defined as; “patient behaviors” that frequently interferes with the effectiveness of treatment for a variety of medical conditions and can have serious medical consequences. While non-adherence is, simply doing medial tasks incorrectly and overtime may jeopardize a patient's outcome.
Defining Patient Non-Compliance
In defining a patient’s non-compliant behavior the four criteria have been suggested: 1) Is the patient’s medical problem potentially serious or does it pose significant risk to life; 2) Has at least one treatment plan, been correctly followed. 3) Has the patient had easy access to the treatment or treatments; and 4) Does the patient deviate, significantly from most patients, with regard to medical advice, treatment, or follow-up care (Kliensinger, Fall 2003, p. 18).
Difficulty with Comply
According to Dr. John Steiner, a researcher at Kaiser Permanente, very few patients are fully capable of complying with all their doctors’ requests and or recommendations. To illustrate his point, he constructed a chart for a theoretical 67-year-old patient with diabetes, hypertension and high blood pressure. He then tabulated what it would take to be “adherent” with all medical recommendations: Five prescriptions to be filled monthly, getting to and from the pharmacy, (assuming he even has insurance), diet (cutting down salt and fats), exercise (three or four times per week), make it to doctors’ appointments, blood tests, check blood sugar, and on top of that, remembering to take the pills every morning and then again every evening eve...

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Kliensinger, M. (Fall 2003). In defining NCB, I use the following. The Permanente Journal, Volume & No. 4.
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