-Compliance implies passive and disinterested. Adherence implies an activated patient who willingly accepts their role and responsibility. So let's stop calling it compliance and start calling it adherence.
-Non-adherence increases morbidity, mortality, and healthcare costs.
-Most common reasons for Intentional Non-adherence:
- Concerns about adverse effects - 65% of new prescriptions for inhaled corticosteroids are not refilled. Inhalation route of steroid administration does not necessarily equate to HPA axis suppression (i.e., growth retardation) or bone density issues.
- Medications are too expensive - Many pharmaceutical firms offer rebates or special pricing for low income patients.
- Not really that sick - Denial is a problem with asymptomatic patients. Conversation should be on the difference between effective long-term symptom control and a 100% cure.
- Not wanting to get “hooked” - An counter to this perception would be to stress that the eventual goal is to achieve an improved overall quality of life.
- Medications no longer work - When a regimen of inhaled corticosteroids is successful, subsequent doses may not be perceived as having any impact, as their role is now more preventative.
- To gain attention - It is important that parents realize, especially with asthma, the possibility a recurrence of symptoms may indeed be the direct result of the child willfully deciding not taking their medications as directed.