Published online June 1, 2005
PEDIATRICS Vol. 115 No. 6 June 2005, pp. e718-e724 (doi:10.1542/peds.2004-1133)
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ELECTRONIC ARTICLE

How Do You Improve Compliance?

Sheldon Winnick, MD*,{ddagger}, David O. Lucas, PhD§, Adam L. Hartman, MD||,¶ and David Toll, MD#

* Private Practice, Lafayette, California
{ddagger} Department of Pediatrics, University of California, San Francisco, California
§ Lucas Science, Lafayette, California
|| Department of Pediatrics, F. Edward Hébert School of Medicine, Uniformed Services University of the Health Sciences, Bethesda, Maryland
Department of Neurology, Johns Hopkins Hospital, Baltimore, Maryland
# Private Practice, St Johnsbury, Vermont

Compliance, or adherence, as it relates to health care is the extent to which a person's behavior coincides with medical or health advice. Medication compliance is critical for all aspects of pediatrics, specifically in successful treatment, disease prevention, and health promotion. Compliance depends on the patient's and physician's committing to the same objectives. It is unfortunate that numerous studies and physician accounts reveal difficulties in achieving compliance with pediatric medication therapy. Medication compliance in pediatric patients ranges from 11% to 93%. At least one third of all patients fail to complete relatively short-term treatment regimens. Poor compliance places children at risk for problems such as continued disease, complicates the physician-patient relationship, and prevents accurate assessment of the quality of care provided. This article presents the issue in the context of its incidence of and barriers to compliance and provides general principles to improve compliance in pediatrics by improving communication and characteristics of the practice setting. A one-on-one relationship between physician and patient is needed for communication and improved compliance.

Key Words: medication • compliance • adherence • prescription • education • physician-patient • dose • duration • palatability • practice • cost

Abbreviations: AAP, American Academy of Pediatrics

Accepted Dec 9, 2004.




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