Patient perspectives: explaining low rates of compliance to compression therapy

Background Although varied interventions are used to prevent venous leg ulcers (VLUs), compression therapy remains the gold standard for VLU prevention and treatment(1-3). However, non-compliance remains an issue. What is it then that makes it difficult for patients to comply? Subsequently, this review paper aims to explain the reasons and contributing factors that attribute to patients' non-compliance to compression therapy with a view of finding strategies that can increase adherence. Method A literature search was undertaken using the terms 'compression therapy', 'compliance' and 'venous leg ulcers'. Articles that reported reasons for non-compliance or adherence to compression therapy were included. Seventeen articles met the inclusion criteria. The reasons for non-compliance were tabulated and subjected to thematic analysis. Results Five determinant themes regarding patients' reasons for non-compliance with compression therapy emerged pain and discomfort, psychosocial issues, knowledge deficit, physical limitations, and financial issues. Discussion Compliance with compression is the key to achieving wound healing in patients with VLUs but compliance rate remains low. Consequently, effort needs to be made by healthcare professionals (HCPs) to improve compliance and therapeutic relationships through holistic patient assessment that addresses their experiences and values their individualism, health beliefs, lifestyle and social networks 45. Further studies to identify intervention strategies that can increase their compliance are required.