Patient Compliance to Health Care Recommendations

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There has been a rising concern about the trend in patient compliance to health care recommendations. This concern for patient’s compliance is more evident on certain health conditions than on others. Barbour, Cohen, Chinnock, Peiperl, and Yamey (2007), argue that approximately half of the patients with tuberculosis (TB) do not comply with their drug prescription. This concern is very critical because noncompliance to treatment lead to disease relapse and subsequent mortality.

Qualitative studies, provides the insight into the justification behind noncompliance by listening to the opinions of the patients, caregivers, and care providers. Munro, Lewin, Smith, Engel, and Fretheim (2007) found a wide set of factors to explain noncompliance such as the idea that after one symptom vanish, it is not necessary to finish the regimen. Such findings help a lot in improving TB treatment and in lowering the huge global burden of TB (p.18).

Various interventions on TB are available. Directly Observed Treatment, Short-course (DOTS) has enhanced tuberculosis control, although better patient compliance is necessary to stop the global tuberculosis prevalence (Munro et al., 2007, p.19). Further, the authors argue that treatment compliance is an intricate issue, and enhancing treatment outcomes for TB demands a full appreciation of the factors that hinder patients from taking medicine appropriately, and those that motivate them to finish their regimen. Qualitative research is the best methodology to investigate this phenomenon because it examines the attitude and the response the treatment elicit from individuals. On the contrary, a quantitative study only depicts the number of noncompliance and its serious consequences. Thus, a qualitative study provides researchers with the orientation for solving the problem of noncompliance. It is through qualitative study that researcher can identify the weakness of a prescription in terms of inconveniences to patient and drug formulation. For instance, oral formulation is more preferred than injection, while short regimen is preferred to long regimens.

With regard to design of this study, I will enroll 100 participants. Of the 100 participants, 30 will be doctors and 70 patients. I will use questionnaires and open-ended interviews respectively. The significant questions were (a) How would you rate patient’s compliance to a specific TB treatment (in a scale of 1 to 10 with 1 signifying least compliance while 10 the most compliance)? (b) Are you comfortable with your TB prescription? What aspect of the treatment do you not like?

The qualitative study, a preventive health education programme for osteoporosis lacks hypothesis or a research question. The study just intends to evaluate the level of attention given to osteoporosis and attract attention to this seemingly undermined condition (Whitehead, Keast, Montgomery, & Hayman, 2004). The quantitative study patient self-medication, on the other hand, has a hypothesis that it seeks to test. The designers of the later study belief that self-medication is a useful approach to management of chronic illness.

The approaches of the studies are different in terms of the data employed for study. The former study design is retrospective because it involved the assessment of already existing preventive osteoporosis services, and determination of clinical challenges. In addition, the study required the participants to reflect on and assess their experiences of adopting a participatory framework.

The later study, on the contrary, employs a prospective research approach. The researchers conducted a pilot study conducted for over six months. The programme of self-medication [SMP] was initiated and researchers needed to give the SMP time to yield outcome. The first study did not enroll any individual participants; instead, it employed group meetings and reflective journals for data collection. The second study involved 220 patients’ participants. The study on patient self-medication had countable results unlike the study on a preventive health education programme for osteoporosis, which did not generate any countable results. Thus, in quantitative study the concept of interest have a countable component, while qualitative study do not, the concept of interest is abstract.

Reference list

Barbour, V., et al. (2007). Qualitative Research: Understanding Patients’ Needs and Experiences. Bethesda: U.S. National Library of Medicine..

Grantham, G., McMillan, V., Dunn, S. V., Gassner l. A & Woodcock, P. (2006). Patient self-medication – a change in hospital practice. Journal of clinical nursing 15, 962–970.

Munro, S., et al. (2007). Patient adherence to tuberculosis treatment: A systematic Review of qualitative research. Bethesda: U.S. National Library of Medicine.

Whitehead, D., Keast, J., Montgomery, V., & Hayman, S. (2004). A preventive health education programme for osteoporosis. Journal of Advanced Nursing, 47(1): 15-24.

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