Types of noncompliance

Noncompliance is a 'catch-all' expression that implies that there is a single type of noncompliant patient who can be managed in one particular way. In reality, there are a variety of behaviours and reasons for noncompliance. It is therefore important that healthcare professionals recognize these behaviours in an attempt to understand why patients are noncompliant. Labels, such as under- or overuse, or unintentional or intentional noncompliance, give no information about either the consequences of, or reasons for, noncompliance. There is probably a large population of noncompliant patients who do not suffer any adverse events as a result of their noncompliance. Patients call adopt different coping styles, e.g. problem-focused and emotion-focused, to deal with unpleasant events, and emotion-based copers can be particularly difficult to manage. Other important aspects of compliance are the costs and benefits for individual patients, which include actual financial costs, drug side-effects, inconvenience, and cultural factors. As a result, healthcare professionals need to focus on each patient's characteristics, in terms of behaviour, motivation and outcome, and develop individualized self-management plans rather than use routine plans for all patients.