An investigation of veterinary client compliance in companion animal practice.

摘要

This investigation examined how well clients follow veterinary medical advice in companion animal practice by determining the level of client compliance with short-term medication prescribed for an acute illness, compliance with long-term medication prescribed for a chronic disease, and compliance with computer generated reminder notices for preventive care. Four methods of assessing compliance were compared in the two medication studies. Median compliance rates in these two studies varied from 100% based on dose taking measures (client self-report and pill count) down to 64% based on electronic monitoring of dose timing. While electronic monitoring continues to be called the 'near gold' standard for assessing compliance, the medication studies revealed that using a combination of the lower of client-reported and pill count as a compliance rate significantly predicted compliance rates assessed by electronic monitoring. The use of electronic monitors was limited by the failure of half of the owners to use the devices properly. Veterinarians were no more able to predict compliance of their clients than physicians can of their patients. The findings of the two medication compliance studies suggest that veterinarians should focus their efforts on choosing appropriate drug therapy with a regimen that fits into a clients lifestyle, giving clear verbal and written medication instructions, and following-up on how owners are giving, and how patients are responding to, the prescribed medication. If one is suspicious that non-compliance may be contributing to treatment failure, asking the client about compliance and performing a pill count at a re-examination will identify many non-compliers and may elicit reasons why non-compliance occurred.; The third study of client response to a clinic recall notice revealed that clients responded to reminders for vaccination about three times less often than for the other recall codes combined (dentals, laboratory tests, medical progress examinations, and neutering). These results are an indication that veterinarians need to move away from sending out annual vaccination reminders and move toward the promotion of preventive veterinary services such as annual wellness examinations, screening laboratory testing, and routine dental procedures. Once a practice has committed to and set up the required computer systems to promote preventive veterinary care, the stage is set for the implementation and monitoring of recommendations and reminders as soon as the veterinarian leaves the examination room. This type of practice philosophy and marketing coincides perfectly with an approach to maximizing compliance in all aspects of veterinary medicine.