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How Fair Is The Term “Noncompliant” When It Comes To Patients?

Most of us have heard the term “noncompliant.” We tend to hear this being said often in the medical world.

Three examples of a patient being labeled as noncompliant include:

  1. a patient can be called noncompliant if he/she doesn’t follow the medication regimen assigned to them by his/her doctor.
  2. a patient doesn’t adhere to follow up schedule recommended by his/her physician.
  3. a patient doesn’t go through the necessary testing (lab work, imaging studies, etc) recommended by his/her physician.

That term, to me, has a negative connotation. It kind of comes off as a politically correct way of saying that someone isn’t doing all they can to help themselves. And while that may be true for a lot of people, that isn’t always the case. Depending on the situation, a noncompliant patient may end up getting a reputation for being stubborn. This, of course, could be spot on. Or, it could not be.

The more I thought about it, the more I realized there are so many reasons for a person to be labeled “noncompliant” that have absolutely nothing to do with their desire to get better or determination to do whatever necessary to have the best quality of life possible.

Five reasons why labeling a patient “noncompliant” isn’t always black and white:

  1. If someone cannot afford their medications, they likely will not take them. That is technically being noncompliant, but it is certainly not the person’s fault.
  2. If a patient is unable to keep regular follow up appointments, it could be because they are too sick to drive. Or, they cannot drive and have no one to help them get to the appointment.
  3. If an individual doesn’t go through necessary testing it could be for a reason as simple as fear. There are many layers of fear I won’t get into now but it is real, especially when it comes to a person’s health and future.
  4. Concern about unknown outcomes and prognosis. Maybe someone prefers to live in denial because they cannot mentally handle what is going on in their world. It is their way of protecting themselves.. at least for the moment.
  5. A patient might not want to make an appointment every few months because copays cost money. Not to mention gas, tolls, and parking.

The bottom line is that there is so much that goes on in the mind of someone who suffers from a chronic illness like Crohn’s Disease or ulcerative colitis. As many of you know, more research is being done to figure out the mental health ramifications of all the trauma a lot of IBD patients have to endure. Post Traumatic Stress Disorder (PTSD) is becoming more commonly diagnosed among people in inflammatory bowel disease (Crohn’s Disease and ulcerative colitis) community.

Therefore, before labeling someone as “noncompliant” or worrying about if you are looked at like that by your doctor or care team, just remember how gray this all is. Black and white doesn’t exist in the world of chronic illness.

This article represents the opinions, thoughts, and experiences of the author; none of this content has been paid for by any advertiser. The InflammatoryBowelDisease.net team does not recommend or endorse any products or treatments discussed herein. Learn more about how we maintain editorial integrity here.

Comments

  • Davethegardner
    3 months ago

    I hate the word “noncompliant.” No medical person has ever called me that to my face, but I’ve given them plenty of reason to. After battling an endless series of respiratory infections while on Humera, I took myself off it. My dr said, “Oh, no, you could have a relapse in 6 months.” That was 4 years ago, and I have managed my gut with very, very careful diet (no gluten, as little sugar as possible, etc.) and have not had a flareup. More than once, I have declined invasive testing, mostly at times when I was in remission but my drs just wanted to see”how I was doing.” Sorry. I can tell you how I’m doing without another darn scope. And about two years ago, I presented my dr with a list of other meds I was quitting (after doing substantial research myself). He said of one of them, “Usually people are on that for life.” I replied that the circumstances under which it was first prescribed do not exist anymore, therefore, I’m stopping it. 12 years ago I had to go onto Home Parenteral Nutrition. When I told my first infusion program that I was going camping, they had a fit and said, “We forbid you to do that.” (Yes, that’s a quote) I went anyway and had no trouble. I know how to maintain a sterile field in challenging circumstances. (I have since switched to another program, much more supportive of my crazy ideas) Noncompliant? You bet. And I am far more in control of my body because of it.

  • crystal.harper moderator
    3 months ago

    I agree that there seems to be a negative connotation with this label and a couple of words certainly doesn’t accurately describe a full situation. I also agree with you on the mental health aspect of any chronic disease. I don’t think there are many people who could go through something so life altering and not be impacted by it mentally, myself included. I think the stigma associated with mental health is starting to go away, but I wish there was still more being done in this area. Thanks for shedding light on the topic!

  • Julie Marie Palumbo moderator
    3 months ago

    This is such an important article and subject to address!

    With the many unknown factors of living with Crohn’s or Colitis, doctors should spend more time asking patients why they are avoiding certain visits, tests, and medications. It would be in the best interest of everyone if they were in agreement and on the same page. The patient would get the level of treatment he/she needs and the doctor will be able to treat him/her appropriately which, at the end of the day, is what doctors strive to do.

    –Julie (Team Member)

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