The Nephrology Department of the Hospital Perpetuo Socorro is a pioneer in Spain in the investigation of this problem in patients. In general, the highest levels of compliance are observed in treatments requiring directly supervised medication and in disorders with an acute onset. The lowest levels are observed in chronic patients in whom there is no immediate discomfort or risk and in those in whom treatment requires a change in lifestyle.
Therapeutic compliance, also called adherence, is a broad concept that refers to the degree to which the patient follows the commitment or pact established with the healthcare professionals (doctors, nurses, etc.) who attend him or her, in relation to the medications to be taken, the following of a diet or changes in lifestyle in general, say the experts in Nephrology.
Are you compliant or not? Fill out this questionnaire
You are non-compliant if you have answered any of these questions as follows: 1: yes, 2: no, 3: yes, 4: yes, 5: C, D or E, 6: more than two days. Any answer in the sense of non-compliant is considered non-compliant.
If your answer is that you are non-compliant, you are one of the 50% of people who do not follow the recommendations of health professionals, and this has important implications.
What are the consequences of therapeutic non-compliance?
1) First and foremost, if the drug was prescribed to achieve certain objectives, not taking it or taking it incorrectly would logically mean that the objectives for which the treatment was intended would not be achieved, which would lead to relapses and a greater number of hospital admissions and, in the long run, deaths. In the face of this “apparent lack of response”, if doctors and nurses believe that the patient is taking his medications or following the diet properly, the logical attitude would be to increase the doses of the medication or add new medications, which would only increase the complexity of the treatment and the risk of side effects.
2) Waste of resources, since the health system (or the patient himself) is paying for drugs that are not actually taken or are taken incorrectly.
Tips for improving adherence
– Ask the healthcare professional to give as much information as possible about the disease, or about how the medication he or she has recommended works. This will help us understand the importance of taking the treatment correctly.
– Ask him to simplify our treatment and to prescribe as few drugs as possible to make it easier to take them correctly.
– We should not leave the consultation until we are clear on the following points: what medications should I take, what for, when should I take them, how should I take them, until when should I take them, how should I take them, how long should I take them?
– Often, when talking to acquaintances, neighbors, friends, relatives, etc., fears or prejudices against a medication may arise, which can sometimes lead us to stop taking it. It can also happen that we have the feeling that we are suffering from some side effect of a medication and we decide not to take it any more. We should explain all this with confidence to a health professional to agree on what is best in each case.
– If it is difficult for us to understand the medication and the schedules, we can ask a family member or friend to accompany us so that they can also explain the treatment.
– If we are elderly, take a large number of medications and have little help at home, we can use a tool called a personalized dosage system (SPD). It consists of weekly cartons prepared at the pharmacy where the different tablets, capsules, etc. are deposited according to the times and days of the week.
– If it is difficult to remember to take the medications, we can use alarms, alarm clocks, reminder notes, or simply leave them in a visible place (kitchen, bedside table).