Treatment Compliance

Compliance Rates and Consequences of Noncompliance

When adults are diagnosed with chronic illnesses, they are often inundated with treatment options. Outright refusal to accept treatment is rare. Many who initially refuse later comply. As M. Robin DiMatteo found, on average, 75.2% of adults with chronic illnesses comply with prescribed treatments. While compliance rates for behavioral interventions (e.g., exercise regimens, smoking cessation) are consistently lower than this average (ranging from 40% to 75%), patients attend scheduled appointments at higher rates (up to 90%). Interestingly, despite the shift toward greater patient decision-making autonomy, across treatment regimens compliance rates have increased from 62.6% prior to 1980 to 76.3% thereafter. Among adults, highest compliance rates are documented for human immunodeficiency virus (HIV), arthritis, and gastrointestinal disorders. While an estimated 50% of children and adolescents with chronic illnesses fully comply with medical recommendations, rates fluctuate depending on the illness. Among children and adolescents with cancer, compliance ranges from 40% to 66%. Compliance for sickle cell disease ranges from 49% to 79%; approximately 66% of patients with cystic fibrosis and diabetes fully comply.

The consequences of noncompliance lie on a continuum ranging from relatively no direct patient risk to severely increased morbidity and mortality and an increased global threat of treatment-resistant diseases. Additionally, noncompliance results in medical resource waste and large-scale medical industry monetary losses exceeding $100 billon per year.