Understanding compliance with the medical regimen: the scope of the problem and a theoretical perspective

This article reviews the scope of the compliance problem and introduces a social cognitive model as a framework for understanding the many factors influencing compliance behaviors. Among the broad categories of factors influencing compliance are the nature of the regimen, immediate controlling factors such as the locale in which the regimen is to be followed, the patients' expectations concerning the regimen, characteristics of the health-care setting, and social support. Each of these factors is considered in some detail. It is concluded that compliance is a complex behavior deserving of thorough investigation by the health-care team, requiring long-term monitoring in chronic health problems, and is susceptible to change by a variety of interventions.