Better Compliance in Preventative Medicine

Introduction

The development of compliance in preventative medicine is a strategic objective for veterinary clinics. Indeed, compliance has a direct impact on the health of the patients, the quality of care, and client satisfaction. Paradoxically, although the majority of veterinary clinics are perfectly aware of how important it is, only a minority of vets truly understand what compliance means, measure it (and thus make it possible to determine the extent of the problem), and implement a conscious strategy to improve it.

One of the first areas of misunderstanding comes from an erroneous interpretation of what compliance really means (Table 1), and compliance should be distinguished from adherence. Compliance measures the overall rate of application of a given preventative measure (for example the annual health check or the annual senior health check) in comparison with the number of animals for which the procedure is indicated. Adherence measures the rate of application of a prescribed treatment (for example wormer/flea treatment or a life-stage diet). Put another way, adherence is related to the clients behavior (and sometimes that of the animal!), whilst compliance involves the team at the clinic first and then that of the client. In veterinary medicine, as in human medicine, compliance rates are highly variable depending on which protocols are selected. In both veterinary and human medicine, healthcare professionals generally over-estimate compliance rates. One study in dogs (1) showed that compliance varied from 87% for basic vaccines to only 35% for dental prophylaxis or annual senior health checks. [...]

Key Points

• Most veterinary practices are aware of how important compliance is, yet very few understand it, measure it or have a conscious strategy to improve it.
• The veterinary team often carries a large part of the responsibility for poor compliance. Good compliance starts by the whole team applying standard protocols consistently.
• Good communication can be underlined by the use of printed matter, but no brochure can ever replace personal communication.
• Effective follow-through is one of the keys to successful compliance, and can make the difference between a mediocre outcome and a truly satisfying result.
• Recording recommendations and follow-through can allow measurement of compliance and enable action to improve it.