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Stop Saying Non-Compliant: A Guide to Strengthening the Clinician-Patient Relationship

Maria Goddard, MD, CWS, FAPWCA began by pointing out that there are differences in the health care space when discussing compliance versus adherence. The phenomenon of patients not following medical advice is not new, but it has significant ramifications on morbidity and mortality. Reports, mostly on medication regimens, estimate 125,000 yearly deaths from a lack of adherence to the prescribed plan.1 There are overarching impacts as well, such as hospitalizations, complications, and higher levels of care. So, who is responsible? The label of “noncompliance” is problematic, which Dr. Goddard discussed throughout her presentation.

Important Definitions to Know

She continued by outlining key differences in the definitions of compliance and adherence. Compliance focuses on the patient’s behavior matching a provider’s recommendations.2 It is more of an order with which the patient is expected to comply. This can put a patient in a position of feeling unheard or devalued. Whereas, adherence is when a patient’s behavior aligns with recommendations agreed upon with a health care provider.2 The key difference, she explained, is in the ”agreement.” This involves a conversation and partnership with the patient about care goals, options, and reasoning. Using the correct terms can make significant differences in attitude and outcomes, she explained.

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1.    Ruppar TM, Cooper PS, Mehr DR, Delgado JM, Dunbar-Jacob JM. Medication adherence interventions improve heart failure mortality and readmission rates: systematic review and meta-analysis of controlled trials. J Am Heart Assoc. 2016;5(6):e002606.
2.    Mir TH. Adherence versus compliance. HCA Healthc J Med. 2023;4(2):219-220.

The views and opinions expressed in this blog are solely those of the author, and do not represent the views of WoundSource, HMP Global, its affiliates, or subsidiary companies.