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Compliance of Patient.

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Compliance of Patient Those patients who do not follow a specified treatment regimen are considered noncompliant. With respect to patient care, the accuracy of a medical diagnosis and the choice of a treatment regimen often are perceived by patients to be more a result of serendipity than rational analysis. This easily can lead to frustration and confusion for the recipient of care. Moreover, patients are not inclined to always follow their treatment protocols and therefore it imposes negative tension in patient-provider relationship. Noncompliance by patients may lead to poor health care outcomes, including a more rapid progression by the patient to the next severity level of the disease, higher costs of treatment as the disease becomes more complicated due to intervening medical conditions, potential malpractice exposure for the health care provider and facility, dissatisfaction expressed by the patient regarding a perceived lack of concern for quality of care. Patient noncompliance or an unwillingness to follow a prescribed treatment plan often results from broad factors such as an established comfort level with the current stage of the disease and a lack of acceptance of the purpose of a particular treatment. For instance, a patient with a chronic disease actually may establish a comfort level with the current stage of the disease. ...read more.


stay, or when an asthmatic decides he no longer needs his daily prophylactic medication and an acute asthma attack requires a visit to the emergency room, hospitalization, and missed work days. These are costly consequences, indeed. A review of approximately 80 disease and care-management programs indicates three distinct approaches for nurses to improving patient compliance with recommended care: 1. Nurse actively participates in equipping the primary care provider with more resources and strategies to reach out to patients; 2. Nurse pays closer attention to nurse-patient interaction; 3. Nurse empowers patients to be more actively involved in decision making and monitoring of their care. Various health programs are turning to nurses to follow up more closely and actively with patients who failed to return for treatment, or for prevention and screening. Thus, the program to improve mammography-screening rates exemplifies this approach. Moreover, in addition to sending reminder postcards quarterly to members who had not had a mammography screening in the previous 18 months, program developed a resource manual for the nurses, according to which nurses call noncompliant members to encourage them to undergo a mammography. A common strategy to get patients to adhere more carefully to their treatment regimens, especially for chronic diseases, is to refer patients to specialized programs managed by nurses. ...read more.


Another approach is to teach patients to use more advanced technology to self-monitor key parameters related to their medical condition and transmit the information to a central location. Nurses follow up with patients whose condition seems to be deteriorating. The congestive heart failure program at Northwestern Healthcare uses this interactive approach. The program employs automated voice technology that is tracked by software. Patients are educated about the phone-in service and then call in daily using the automated technology with information about their weight and symptoms. Then software generates a report that identifies patients whose status has changed and who is in need of follow up. A nurse then phones the patients. By calling in daily, patients are made aware of the importance of paying attention to their symptoms and their weight. The educational component empowers them to be in charge of specific aspects of their care, and 85% to 90% of patients comply with daily self-reporting. The program also includes monthly feedback reports and graphs to the patients. These examples demonstrate how health plans and nursing staff are actively intervening to help members get preventive care and patients to adhere to their treatment regimens and manage their conditions more effectively. This process requires nurses to carefully identify and follow members and patients in need, educate and train patients to be aware of their healthcare needs and monitor their health status, and follow up closely to maintain positive outcomes. ...read more.

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