Do we Know Why Patients Don’t Comply?

            I was just reading an interesting article about compliance.  Lack of compliance is one of the biggest enemies we fight in our profession.  How do we get our patients to actually perform our recommendations?  First, we need to understand why they don’t always comply.

            The study outlined in the article, found that half of all patients fail to follow a clinician’s instructions.  This is mainly due to one or a combination of the following reasons: 

1. Fear—Not only the common fear in being in a dental office, but a fear of discovering health concerns while performing their home-care routine. It sounds counter-intuitive, but it is fairly common for a person to notice something wrong and ignore it out of fear of a serious diagnosis. 
2. Lack of information—Explaining the big picture and the progression of the disease along with options to attack the issues helps increase compliance. 
3. Socioeconomic status—Sometimes recommended treatment takes a backseat to necessities. Understandably, basic needs like food and shelter are the priority within a limited budget.
4. Perception of the clinician—If we are not up-to-date or knowledgeable on the topics we are discussing with patients, our recommendations will not be taken seriously.
5. Involvement in decision-making—We need to fully inform patients so they can make educated decisions about their future treatment.  If they don’t feel involved then they won’t comply.

           Understanding where our patients’ hesitation stems can help us increase their compliance.  Making sure they have all the facts is also important.  I never want a patient to come back and say, ‘she never told me’.  If anything, I may have put a few on information overload.  But I need them to understand what is happening in their mouth and how to make it right.  The next time a patient just won’t comply, think about what could be hindering them.

Lee, C. T., Huang, H. Y., Sun, T. C., & Karimbux, N. (2015). Impact of patient compliance on tooth loss during supportive periodontal therapy a systematic review and meta-analysis. Journal of dental research, 0022034515578910.