Making Outpatient Care of Diabetes More Efficient: Analyzing Noncompliance

S. B. Leichter
2005 Clinical Diabetes  
wo recent brief articles 1, 2 in this "Business of Diabetes" department focused on common issues that may worsen clinical outcomes of outpatient diabetes care and make the care process more prolonged and complex. These issues were depression and borderline personality disorder, and both are examples of a multitude of problems that result in the failure of diabetic patients to adhere to the medical prescription for their condition. The effort to deal with the negative consequences of
more » ... e prolongs the outpatient visit and makes service more complex. Perhaps no aspect of outpatient diabetes care seems as frustrating to primary care providers as the problems that result in nonadherence. In our program, we have developed a menu of brief, simple assessments to identify the factors that contribute to this overall problem. "Nonadherence" Versus "Noncompliance" Some years ago, diabetes educators argued that the term "adherence" be used preferentially instead of "compliance," and the term "nonadherence" be substituted for "noncompliance." 3 The rationale for this proposal was that the term "noncompliance" implies a series of negative value judgments about patients as people. Instead, the term "nonadherence" was thought to imply a description of a failure to follow the medical prescription without any bias toward the patient as a person. Most authorities have endorsed this view. 4 In addition, specific studies have noted that nonadherence may entail various com-187
doi:10.2337/diaclin.23.4.187 fatcat:hnyxqgti4vdhpn6enerlxppeza