The effect of patient-practitioner interaction on compliance: a review of the literature and application in rheumatoid arthritis.

Persons with rheumatoid arthritis, like those with other chronic illnesses, often demonstrate poor compliance with their treatment regimens. Numerous factors have been identified as influencing compliances, including various features of diseases and therapeutic regimens, and demographic and sociobehavioral features of patients. Perhaps the most significant factor is the physician-patient relationship. Because of the relatively high prevalence of rheumatoid arthritis and the numerous characteristics of the disease and its treatment which adversely affect compliance, this literature review deals with the effects of the patient-practitioner interaction on compliance with treatment programs for rheumatoid arthritis. Specifically, this review examined the reported effects of four components of the patient-practitioner interaction--pedagogical techniques, sharing of expectations, the patient's assumption of responsibility and affective tone. Based on this literature review, several suggestions are provided for the health professional regarding ways to enhance compliance through the interaction with the patient, and specific areas for further research are identified.