it is a very important topic in healthcare management. Pharmacist being the end point of contact for medicine use, he/she must be very careful in explaining the same to the patients while dispensing.

1. PATIENT COMPLIANCE
Mrs. Mayuri Padhye, Assistant Professor,
Department of Pharmacology,
Saraswathi Vidya Bhavan’s College of Pharmacy

2. PATIENT COMPLIANCE
 NEED
 METHODS OF ASSESSMENT
 REASONS FOR NON-COMPLIANCE
 STRATEGIES FOR IMPROVING
COMPLIANCE

3. NEED
 It is well documented that safe and effective
drug therapy most frequently occurs when
patients are well-informed about medications
and their use.
e.g. A person suffering from diabetes and
hypertension is prescribed anti-
hyperlipidemic tablet though the lipid profile is
normal as a prophylactic purpose

4. NEED
 Pharmacist is the professional who
supervises the dispensing of medicines
immediately before use and therefore
assumes the key role in making certain that
potential non-compliance is reduced to
minimum.

5. NEED
 The reasons for non-compliant behavior
are complex and cannot be generalized.
 Poor compliance can have serious
repercussions in some disease.
E.g. Omission of few doses of insulin may
be life-threatening.

6. METHODS OF ASSESSMENT
1. Interrogation :
With the use of standard questionnaire to
assess
inconvenience of side effects.
2. Residual Tablet Counting:
Tablet count may be performed on a regular
basis,
but this is an inaccurate method.

7. METHODS OF ASSESSMENT
3. Urine markers:
A simple urine marker Riboflavin may be added in
The dosage regimen. Its presence in the urine
may
be noted for more accurate assessment of
compliance.
4. Drug Analysis:
Specific and sensitive methods of analysis can be
used to detect potent therapeutic agent in body
fluids.
E.g. Digoxin, Phenytoin

8. REASONS FOR NON-COMPLIANCE
1. Poor Standards Of Labeling:
 The labels on medication containers must
be clear and specific.
The instructions like ‘ Take As Required’
or ‘Use As Directed’ are not specific.
Poorly handwritten labels are a major
source of medication error.

10. REASONS FOR NON-COMPLIANCE
2. Inappropriate Packing:
Many elderly patients have difficulty in
opening the container, specially if the size
is too small or the cap is difficult to
unscrew.
The blister pack may be too rigid or the
glass bottle may be fragile, making
handling difficult.

11. REASONS FOR NON-COMPLIANCE
3. Complex Therapeutic Regimen:
The degree on non-compliance is directly
related to the complexity of the
medications prescribed.
Patients have usually to take different
drugs at varying time intervals during the
day.
It is difficult memorize and result in
unintentional non-compliance.

12. REASONS FOR NON-COMPLIANCE
4. Nature Of Medication:
Preparations with an unpleasant taste,
color or odor, predispose patients
particularly children towards non-
compliance.
Extremely small tablets difficult to handle

13. REASONS FOR NON-COMPLIANCE
4. Nature Of Medication:
Large tablets may be difficult to swallow
Liquids oral formulations may be difficult to
transport.

14. REASONS FOR NON-COMPLIANCE
5. Deliberate Deviation:
Some patients believe that once they begin
to feel better, they may stop the treatment.
e.g. Development of resistance to
Antimicrobial agents
Doses may be completely omitted due to
forgetfulness.

15. STRATEGIES FOR IMPROVING
COMPLIANCE
1. Simplification Of The Therapeutic
Regimen:
Patient compliance may be obtained by
minimizing the complexity of the
therapeutic regimen.
Physicians must prescribe a minimum
number of drugs with well defined dosage
schedule.
E.g. Sustained release preparations
Long acting preparations

16. STRATEGIES FOR IMPROVING
COMPLIANCE
1. Simplification Of The Therapeutic
Regimen:
Some fixed dose combinations for
therapeutic benefit
 Therapeutic synergism: Co-trimoxazole
 Reduction in side effects: and
improvement in the therapeutic effect:
Levodopa & Carbidopa

17. STRATEGIES FOR IMPROVING
COMPLIANCE
2. Improving Standards of Dispensing
Practice:
The container size should be appropriate
to accommodate a label bearing dosage.
High quality containers must be selected.
 Geriatric Population: Palm size container
 Pediatric Population: Child Resistant
container

18. STRATEGIES FOR IMPROVING
COMPLIANCE
2. Improving Standards of Dispensing
Practice:
Pharmacist should take the initiative to
detail the ideal times of administrations.
Specific instructions must be given.
Exact mode of administration and storage
conditions should be illustrated.

19. STRATEGIES FOR IMPROVING
COMPLIANCE
3. Development Of Suitable Medication
Packaging :
Pharmacist should select the system of
presentation and packaging of medicines
which is most appropriate for the needs of
individual patient.
Unit Dose pack.

20. STRATEGIES FOR IMPROVING
COMPLIANCE
4. Supplementary Labeling:
Supplementary labeling instructions are
recommended to convey important data
regarding drug administration.
 Description of drug action in lay
terminology.

21. STRATEGIES FOR IMPROVING
COMPLIANCE
4. Supplementary Labeling:
 Symbols and graphics may be used to
emphasize the correct times of administration.
 A ‘Daily Calendar’ or a ‘Tablet Identification
Card’ bearing details of the administration
schedule may be given to improve
compliance.

22. STRATEGIES FOR IMPROVING
COMPLIANCE
5. Patient Counseling and Education:
If patients do not adhere to the directions
given by their physician , the following may
be the interlinked consequences:
 Failure of treatment
 Increased chances of adverse reactions
 Increased chances of hospitalization
 Increased medical and non-medical
expenditure
 Decreased quality of life

23. STRATEGIES FOR IMPROVING
COMPLIANCE
5. Patient Counseling and Education:
It aims to enhance patient’s understanding
of their illness and its treatment so that
they are informed about medication use.
It improves Patient-Pharmacist
relationship.

24. PRECAUTIONS AND DIRECTIONS FOR MEDICATION
AND ADMINISTRATIVE INSTRUCTIONS
 The pharmacist should convey the Precautions
and Special directions applicable to various
medical conditions and disease states to the
patient.
 The proper use of medication must be explained
to the patient.
 It reduces non-compliance.

27. HOW INSTIL THE EYE DROPS

29. HOW TO USE
INHALER?
HOW TO USE BAND-AID?

30. HOW TO APPLY SUNSCREEN LOTION
1. Choose a sunscreen
2. Go home and try a small portion
around your wrist
3. On the day you will be in the sun, 30
minutes before you go outside, apply
an ounce of sunscreen
4. To apply sunscreen, squeeze a dollop
of cream sunscreen onto your hand
and rub it all the skin that will be
exposed to the sun

31.  Q. Write a note on Patient Compliance.
3M

32. THANK YOU