Regimen adherence problems are
common in individuals with diabetes, making glycemic control difficult to
attain. Because the risk of complications of diabetes can be reduced by proper
adherence, patient nonadherence to treatment recommendations is often
frustrating for diabetes health care professionals. This article reviews the
scope of the adherence problem and the factors underlying it.
Most health care providers use
the term “compliance” instead of “adherence,” although these concepts are quite
different. Compliance has been defined as “the extent to which a person's
behavior coincides with medical advice.” Noncompliance then essentially means
that patients disobey the advice of their health care providers. Patient
noncompliance is attributed to personal qualities of the patients, such as
forgetfulness, lack of will power or discipline, or low level of education. The
concept of noncompliance not only assumes a negative attitude toward patients,
but also places patients in a passive, unequal role in relationship to their
care providers.
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