Should we consider non-compliance a medical error?
Non-compliance is an extensive intractable problem. This paper argues that we can gain significant insight into non-compliance if we apply theories developed to explain human error in organisations. The resultant framework encompasses intentional and unintentional non-compliance, shifts blame from the patient, and recognises the influence of other factors, including organisational ones. There are also consequences for the measurement of compliance and new strategies to improve it. Terminology will need to be addressed, particularly whether intentional non-compliance by a patient should be considered an error. If empirical research supports the arguments in this paper then, with some further theory development, the application of human error theory will offer a useful new approach to understanding and reducing undesired non-compliance.
Barber
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Centre for Practice and Policy, School of Pharmacy, 29-39 Brunswick Square, London WC1N 1AX, UK. nick.barber@ulsop.ac.uk
D003142:Communication; D019983:Guideline Adherence; D006302:Health Services Research; D006801:Humans; D008508:Medication Errors / Q000145:classification* / Q000517:prevention & control; D017146:Models, Organizational; D010817:Physician-Patient Relations; D011582:Psychological Theory; D012646:Self Administration / Q000523:psychology*; D016312:Treatment Refusal; D006113:United Kingdom