Patient compliance: A concept analysis


concept analysis
healthcare profession

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Thummak, S., Uppor, W., & Wannarit, L.-O. . (2023). Patient compliance: A concept analysis. Belitung Nursing Journal, 9(5), 421–427.
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Accepted for publication: 2023-09-28
Peer reviewed: Yes

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Background: Patient compliance with regimens is one of the most researched and least-understood behavioral concerns in the healthcare profession due to the many meanings employed in multidiscipline over time. Thus, a thorough examination of the idea of patient compliance is necessary.

Objective: This paper aims to explore and identify the essence of the term patient compliance to achieve an operational definition of the concept.

Method: Walker and Avant’s eight-step approach was used. A literature search was conducted using keywords of patient compliance AND healthcare profession from five databases: PubMed, Medline, CINAHL, ProQuest, ScienceDirect, and Cochrane database, published from 1995 to 2022.

Results: The attributes of patient compliance include 1) self-care behavior, 2) following health recommendations, and 3) willing collaboration with health professionals. Antecedents of patient compliance were characteristics of therapeutic regimens, communication of health advice, and patients’ attitudes toward professional recommendations. Consequences include improved clinical outcomes, quality of life, and lifestyle or behavior modification.

Conclusion: This concept analysis offers a valuable perspective on patient compliance that guides the nursing practice in providing better interventions to promote compliance among patients.


Copyright (c) 2023 Saowaluk Thummak, Wassana Uppor, La-Ongdao Wannarit

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This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

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Declaration of Conflicting Interest

The authors declared no conflict of interest.


This article was developed from a class assignment for a PhD in the course of Theory and Development in Nursing. Thus, our gratitude goes to the professors who gave us constant guidance and support. Special thanks to Dr. Kay Coalson Avant, a special teacher in the subject. This paper would have never been accomplished without their assistance and dedicated involvement in every step of the process.

Authors’ Contributions

ST conceptualized, designed, and analyzed. WU contributed to designing, analyzing, drafting, and reviewing the manuscript. LOW drafted the manuscript and reviewed it. All authors provided final approval of the version to be published. All authors contributed equally to this study, and they read and approved the final manuscript and were accountable and entirely responsible for its content. The author meets four authorship criteria based on ICMJE Recommendations.

Data Availability

Not applicable.

Ethical Consideration

Not applicable.


Abdallah, D. M., Taha, N. M., Mohamed, E. H., & Saleh, M. D. (2023). Factors affecting compliance of therapeutic regimen among patients with multiple sclerosis. Zagazig Nursing Journal, 19(2), 1-12.

Ali, A. A., Abderraman, G. M., Tondi, Z. M. M., & Mahamat, H. A. (2019). Compliance of hypertensive patients with antihypertensive drug therapy at the Renaissance Hospital of N’Djamena, Chad. Annals of Clinical Hypertension, 3(1), 47-51.

Alikari, V., & Zyga, S. (2014). Conceptual analysis of patient compliance in treatment. Health Science Journal, 8(2), 179-186.

Aremu, T. O., Oluwole, O. E., Adeyinka, K. O., & Schommer, J. C. (2022). Medication adherence and compliance: Recipe for improving patient outcomes. Pharmacy, 10(5), 106.

Basmakci, A., Kutlu, O., Kalyon, S., Sertdemir, T., & Mine, A. (2022). Diabetic patients’ compliance with treatment during COVID-19 pandemic period. Journal of Istanbul Faculty of Medicine, 85(4), 485-493.

Berek, P. A. L., & Afiyanti, Y. (2020). Compliance of hypertension patients in doing self-care: A grounded theory study. JurnalSahabat Keperawatan, 2(1), 21-35.

Berendsen, A. J., Groenier, K. H., de Jong, G. M., Meyboom-de Jong, B., van der Veen, W. J., Dekker, J., de Waal, M. W. M., & Schuling, J. (2009). Assessment of patient's experiences across the interface between primary and secondary care: Consumer Quality Index Continuum of care. Patient Education and Counseling, 77(1), 123-127.

Bunting, J., & de Klerk, M. (2022). Strategies to improve compliance with clinical nursing documentation guidelines in the acute hospital setting: A systematic review and analysis. SAGE Open Nursing, 8, 23779608221075165.

Chatterjee, J. S. (2006). From compliance to concordance in diabetes. Journal of Medical Ethics, 32(9), 507-510.

Cheraghi, M. A., Pashaeypoor, S., Dehkordi, L. M., & Khoshkesht, S. (2021). Creativity in nursing care: A concept analysis. Florence Nightingale Journal of Nursing, 29(3), 389–396.

Costa, K. F. d. L., Vieira, A. N., Bezerra, S. T. F., Silva, L. d. F. d., Freitas, M. C. d., & Guedes, M. V. C. (2021). Nursing theory for patients’ compliance with the treatments of arterial hypertension and diabetes mellitus. Texto & Contexto-Enfermagem, 30.

Cramer, J. A., Roy, A., Burrell, A., Fairchild, C. J., Fuldeore, M. J., Ollendorf, D. A., & Wong, P. K. (2008). Medication compliance and persistence: Terminology and definitions. Value in Health, 11(1), 44-47.

Cushing, A., & Metcalfe, R. (2007). Optimizing medicines management: From compliance to concordance. Therapeutics and Clinical Risk Management, 3(6), 1047-1058.

Desai, R., Thakkar, S., Fong, H. K., Varma, Y., Khan, M. Z. A., Itare, V. B., Raina, J. S., Savani, S., Damarlapally, N., & Doshi, R. P. (2019). Rising trends in medication non-compliance and associated worsening cardiovascular and cerebrovascular outcomes among hospitalized adults across the United States. Cureus, 11(8), e5389.

Doran, J. M., Safran, J. D., Waizmann, V., Bolger, K., & Muran, J. C. (2012). The Alliance Negotiation Scale: Psychometric construction and preliminary reliability and validity analysis. Psychotherapy Research, 22(6), 710-719.

Dutt, S. (2017). Importance of patient adherence and compliance in the present day. Journal of Bacteriology and Mycology Open Access, 4(5), 150-152.

Dwairej, L. A., Ahmad, M. M., & Alnaimat, I. A. (2020). The process of compliance with self-care among patients with hypertension: A grounded theory study. Open Journal of Nursing, 10(5), 534-550.

Ehwarieme, T. A., Ogbogu, C. J., Chisom, M., & Obiekwu Adaobi, L. (2018). Compliance to treatment regimen among diabetic patients attending outpatient department of selected hospitals in Benin City, Edo State. Journal of Public Health and Epidemiology, 10(4), 97-107.

Ekinci, F., Tuncel, B., Coşkun, D. M., Akman, M., & Uzuner, A. (2017). Effects on blood pressure control and compliance for medical treatment in hypertensive patients by sending daily sms as a reminder. Konuralp Medical Journal, 9(2), 136-141.

Garabeli, A. A., Daher, J. B., Wiens, A., Lenzi, L., & Pontarolo, R. (2016). Quality of life perception of type 1 diabetic patients treated with insulin analogs and receiving medication review with follow-up in a public health care service from Ponta Grossa-PR, Brazil. Brazilian Journal of Pharmaceutical Sciences, 52, 669-677.

Ibrahim, N. K. R., Attia, S. G., Sallam, S. A., Fetohy, E. M., & El-Sewi, F. (2010). Physicians’ therapeutic practice and compliance of diabetic patients attending rural primary health care units in Alexandria. Journal of Family and Community Medicine, 17(3), 121-128.

Jansiraninatarajan. (2013). Diabetic compliance: A qualitative study from the patient’s perspective in developing countries. IOSR Journal of Nursing and Health Science, 1(4), 29–38.

Jin, J., Sklar, G. E., Min Sen Oh, V., & Chuen Li, S. (2008). Factors affecting therapeutic compliance: A review from the patient’s perspective. Therapeutics and Clinical Risk Management, 4(1), 269-286.

Khan, A. R., Lateef, Z. N. A.-A., Al Aithan, M. A., Bu-Khamseen, M. A., Al Ibrahim, I., & Khan, S. A. (2012). Factors contributing to non-compliance among diabetics attending primary health centers in the Al Hasa district of Saudi Arabia. Journal of Family and Community Medicine, 19(1), 26-32.

Krot, K., & Sousa, J. P. (2017). Factors impacting on patient compliance with medical advice: Empirical study. Engineering Management in Production and Services, 9(2), 73-81.

Kyngäs, H. (2000). Compliance of adolescents with diabetes. Journal of Pediatric Nursing, 15(4), 260-267.

Lu, X., Zhang, R., Wu, W., Shang, X., & Liu, M. (2018). Relationship between internet health information and patient compliance based on trust: Empirical study. Journal of Medical Internet Research, 20(8), e253.

Luciani, M., De Maria, M., Page, S. D., Barbaranelli, C., Ausili, D., & Riegel, B. (2022). Measuring self-care in the general adult population: development and psychometric testing of the Self-Care Inventory. BMC Public Health, 22, 598.

Martin, C. J. H., & Bull, P. (2008). Obedience and conformity in clinical practice. British Journal of Midwifery, 16(8), 504-509.

Memon, K. N., Shaikh, N. Z., Soomro, R. A., Shaikh, S. R., & Khwaja, A. (2017). Non-compliance to doctors’ advices among patients suffering from various diseases: Patients’ perspectives: A neglected issue. Journal of Medicine, 18(1), 10-14.

Mir, T. H. (2023). Adherence versus compliance. HCA Healthcare Journal of Medicine, 4(2), 22.

Muliyil, D. E., Vellaiputhiyavan, K., Alex, R., & Mohan, V. R. (2017). Compliance to treatment among type 2 diabetics receiving care at peripheral mobile clinics in a rural block of Vellore District, Southern India. Journal of Family Medicine and Primary Care, 6(2), 330-335.

Murphy, J., & Coster, G. (1997). Issues in patient compliance. Drugs, 54, 797-800.

Naghavi, S., Mehrolhassani, M. H., Nakhaee, N., & Yazdi-Feyzabadi, V. (2019). Effective factors in non-compliance with therapeutic orders of specialists in outpatient clinics in Iran: A qualitative study. BMC Health Services Research, 19, 413.

Ogbemudia, E. J., & Odiase, F. E. (2021). Poor compliance with lifestyle modifications and related factors in hypertension. Highland Medical Research Journal, 21(1), 57-62.

Oxford Learner's Dictionaries. (2023a). Patient. In Oxford Learner’s Dictionaries.

Oxford Learner's Dictionaries. (2023b). Compliance. In Oxford Learner's Dictionaries.

Prigge, J.-K., Dietz, B., Homburg, C., Hoyer, W. D., & Burton, J. L. (2015). Patient empowerment: A cross-disease exploration of antecedents and consequences. International Journal of Research in Marketing, 32(4), 375-386.

Rae, B. (2021). Obedience to collaboration: Compliance, adherence and concordance. Journal of Prescribing Practice, 3(6), 235-240.

Rao, C. R., Kamath, V. G., Shetty, A., & Kamath, A. (2014). Treatment compliance among patients with hypertension and type 2 diabetes mellitus in a coastal population of Southern India. International Journal of Preventive Medicine, 5(8), 992-998.

Riegel, B., Barbaranelli, C., Sethares, K. A., Daus, M., Moser, D. K., Miller, J. L., Haedtke, C. A., Feinberg, J. L., Lee, S., & Stromberg, A. (2018). Development and initial testing of the self‐care of chronic illness inventory. Journal of Advanced Nursing, 74(10), 2465-2476.

Saiz, A., Mora, S., & Blanco, J. (2015). Treatment compliance with first line disease-modifying therapies in patients with multiple sclerosis. Compliance study. Neurología (English Edition), 30(4), 214-222.

Sen, H. T. N., Linh, T. T. T., & Trang, D. T. K. (2020). Factors related to treatment compliance among patients with heart failure. Ramathibodi Medical Journal, 43(2), 30-40.

Shrestha, K. D., Takma, K. C., & Ghimire, R. (2019). Predictors of treatment regimen compliance and glycemic control among diabetic patients attending in a tertiary level hospital. Journal of Nepal Health Research Council, 17(3), 368-375.

Sidani, S., & Doran, D. I. (2014). Development and validation of a self-care ability measure. Canadian Journal of Nursing Research 11-25.

Sweileh, W., Aker, O., & Hamooz, S. (2004). Rate of compliance among patients with diabetes mellitus and hypertension. An-Najah University Journal for Research-A (Natural Sciences), 19(1), 1-11.

Tun, H. (2021). Importance of medication compliance and lifestyle modification in heart failure readmission: Single centre cohort study. European Journal of Preventive Cardiology, 28(Supplement_1), zwab061-030.

Umaki, T. M., Umaki, M. R., & Cobb, C. M. (2012). The psychology of patient compliance: A focused review of the literature. Journal of Periodontology, 83(4), 395-400.

van der Wal, M. H. L., Jaarsma, T., Moser, D. K., van Gilst, W. H., & van Veldhuisen, D. J. (2010). Qualitative examination of compliance in heart failure patients in The Netherlands. Heart & Lung, 39(2), 121-130.

Vrijens, B., De Geest, S., Hughes, D. A., Przemyslaw, K., Demonceau, J., Ruppar, T., Dobbels, F., Fargher, E., Morrison, V., & Lewek, P. (2012). A new taxonomy for describing and defining adherence to medications. British Journal of Clinical Pharmacology, 73(5), 691-705.

Walker, L. O., & Avant, K. C. (2019). Strategies for theory construction in nursing (6th ed.). Upper Saddle River, NJ: Pearson.

Warren Findlow, J., Basalik, D. W., Dulin, M., Tapp, H., & Kuhn, L. (2013). Preliminary validation of the hypertension self‐care activity level effects (H‐SCALE) and clinical blood pressure among patients with hypertension. The Journal of Clinical Hypertension, 15(9), 637-643.

Wu, D., Lowry, P. B., Zhang, D., & Parks, R. F. (2021). Patients’ compliance behavior in a personalized mobile patient education system (PMPES) setting: Rational, social, or personal choices? International Journal of Medical Informatics, 145, 104295.

Zulfa, I. M., & Handayani, W. (2020). Patient’s compliance with oral antibiotics treatments at community health centers in Surabaya: A 20-KAO Questionnaire Development. Borneo Journal of Pharmacy, 3(4), 262-269.

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