Adherence to medical recommendations is recognized as an important factor in positive patient outcomes. It has been evaluated to a limited extent in veterinary medicine with reported adherence rates anywhere from 30 to 89%. The objective of this evaluation was to examine adherence to written instructions provided to veterinary dermatology clients as part of a quality assurance assessment of our program.
Cat and dog owners of returning dermatology patients completed a questionnaire to report how well written recommendations on printed discharge notes were followed. Adherence rates were calculated and contributing factors were evaluated.
Adherence was evaluated for 75 patients at 93 different recheck visits to the dermatology service. Where a recheck visit date had been previously recommended, 89% occurred within 1 week of that date. Overall, the average rate of adherence to written instructions was 74%. Adherence rates varied by category of recommendation (p<0.001): diet changes had the highest adherence (100%) while recommendations requiring changes to owner or pet behavior had the lowest (17%). Adherence to medication instructions (the most common category) was 75% overall, but lower for medicated shampoo (62%) and other topicals (58%). Adherence to grooming or cleaning recommendations was 58%. There was some evidence that format of the discharge instructions had an effect on adherence with simplified itemized list having higher adherence than paragraph form (78% versus 71%, p=0.046).
Overall, adherence varied based on recommendation category and format. Adherence was higher than previously reported in general practice, which could be attributed to the nature of specialty medicine.
MOSS Anne1, TUREK Michelle2*, MORIELLO Karen3, BUHR Kevin4, HAYIM Rubi5 1School of Veterinary Medicine, University of Wisconsin-Madison, Madison, WI USA 2Department of Surgical Sciences, School of Veterinary Medicine, University of Wisconsin-Madison, Madison, WI USA 3Department of Medical Sciences, School of Veterinary Medicine, University of Wisconsin-Madison, Madison, WI USA 4Department of Biostatistics and Medical Informatics, University of Wisconsin-Madison, Madison, WI, USA 5UW Veterinary Care, School of Veterinary Medicine, University of Wisconsin-Madison, Madison, WI USA