Adherence = taking your medication in the manner and amount recommended by the clinician.

When patients have trouble adhering to treatment plans, we must stop to consider: what obstacles do they face and why?

We keep asking why because there are a number of reasons why patients and families might have difficulty with a treatment plan and they may not speak up for themselves. This is also why we use the term adherence rather than compliance, as compliance implies one-sided directives in which responsibilities and failures would belong only to patients.

In order to understand obstacles to adherence, think about things like…

1. frustration and lack of trust with the medical system (e.g. chronic illness & increasing severity of illness, economic resources, racial bias, etc.)
2. accessibility of medical resources (e.g. hospitals, outpatient clinics, Rx’s, etc.)
3. time constraints (e.g. work hours, family responsibilities, etc.)
4. understanding of the severity of the condition (e.g. denial, hopefulness, etc.)

Treatment plans are not one size fits all and require attentiveness to diversity, equity and inclusion in order for them to be efficacious. They may also require stronger relations, as opposed to punitive rules, in order to achieve desired results.

• Video: Culturally Competent Healthcare: Improving Patient Medication Adherence
• Wendell, Susan (1996). The Social Construction of Disability. The Rejected Body. New York : Routledge