9990 · 3.2.3
Improving adherence — FAQ
Frequently asked questions for 9990 Improving adherence. Direct answers first, then deeper explanation — then practise with marking.
Isn't non-adherence just the patient's fault? Why do we need interventions?
This is a common misconception. Non-adherence is a complex issue influenced by many factors, including the complexity of the treatment, side effects, communication with the practitioner, and patient beliefs. It is rarely a simple case of a patient deliberately refusing treatment. Interventions are needed to address these multiple barriers, viewing it as a healthcare problem to be solved collaboratively, not a personal failing.
What's the difference between 'adherence' and 'compliance'?
While often used interchangeably, there is a subtle but important difference. 'Compliance' implies a passive model where the patient obediently follows the doctor's orders. 'Adherence' suggests a more active, voluntary choice by the patient to follow the recommended treatment plan. The term 'concordance' takes this further, emphasising a collaborative partnership where the patient and practitioner make a joint decision about treatment. Cambridge exams often use 'adherence', reflecting this modern understanding.
Are expensive, high-tech interventions always better than simple ones?
Not necessarily. The effectiveness of an intervention depends on the specific reason for non-adherence. A simple, inexpensive pill organiser (a behavioural prompt) might be highly effective for a patient who is merely forgetful. Conversely, a sophisticated app might be useless for a patient who is non-adherent due to a deep-seated fear of side effects. The best intervention is one that is tailored to the individual patient's needs and barriers, which may well be a low-cost, simple solution.