Under Compliance, we define the extent to which the patient’s behavior complies with the medical recommendations that he received, or the degree of compliance with the medical recommendations. The degree of diligence directly reflects the effectiveness of communication with the doctor, being a reflection of the patient’s motivation, although there is no direct connection here. Thus, patients with insufficient motivation can passively but strictly follow medical recommendations, and vice versa. As a rule, Compliance can only be assessed retrospectively, de facto.

The implementation of medical recommendations determines the results of treatment. But some patients don’t follow the recommendations. To understand this, it is necessary to consider two groups of reasons.

The first group is associated with imperfect medical practice. Lack of authority, superficial interaction between doctor and patient, illegible and contradictory recommendations, lack of consensus between doctors and a doctor’s lack of faith in the success of treatment are all good reasons for poor Compliance. Drug regimens require separate discussion. The use of a large number of drugs in one scheme and the high frequency of their intake are directly related to a decrease in Compliance.

The second group of reasons why medical recommendations are not followed is related to the attitude of the patients themselves. In most cases, this is low motivation for treatment (discussed in the corresponding article). The most common reason for this is an underestimation of the importance of treatment and a lack of faith in its effectiveness. There is also a separate group of patients that we call “smart patients”. They interpret medical prescriptions quite freely, based on their own understanding of medical problems. They vary their drug regimens independently, and the ineffectiveness of treatment is not associated with their own interference in the treatment process.

The problem is that doctors are often not informed about the changes and continue to react to the lack of effect by further increasing doses, introducing new or replacing old drugs. All these increase the number of drugs used, respectively, the risk of side effects and further reduces Compliance. A vicious circle is created with a broken feedback mechanism. “Smart patients” are able to disguise the reduced compliance in different ways. The most common is the accentuation of the side effects of drugs, which, as a rule, is acutely perceived by the doctor, forcing him to immediately stop treatment.

The lack of obligation to follow medical recommendations has another negative effect – it affects the doctor’s motivation to help the patient. It is not difficult for a doctor with experience to understand how much his work is in demand, and after several attempts to explain it, a situation may arise that the doctor seems to be treating or so, and the patient is being treated or so. The implementation of medical recommendations is a conscious right of the patient, determined by a specific medical situation, reflecting confidence in the doctor and determining the results of treatment.

Therefore, a normal situation is when the volume of treatment is coordinated with the patient at the beginning, and in the process it is carried out as accurately as possible and, if necessary, is jointly coordinated.