Noncompliance in community psychiatry: a review of clinical interventions

A substantial number of psychiatric patients seen in community settings fail to comply with treatment. Noncompliance takes many forms, including failure to keep initial appointments, to complete outpatient referrals from emergency services, to keep aftercare appointments following hospitalization, to remain in treatment, and to take prescribed medication. The author reviews the literature on noncompliance in community settings and discusses interventions that have been found to reduce noncompliance. Based on the review, four general recommendations for improving patient compliance are given; they are scheduling appointments before release from inpatient treatment, shortening the waiting period for appointments, using prompts in the form of letters and telephone calls to encourage patients to keep their appointments, and offering orientation and education about treatments and medications.