Compliance and adherence are dysfunctional concepts in diabetes care

Diabetes Educ. Jul-Aug 2000;26(4):597-604. doi: 10.1177/014572170002600405.


Recognizing that adherence and compliance are dysfunctional concepts is not a passing fad or the latest trend in behavioral approaches to diabetes care and education. Shifting from the acute-care/compliance-focused paradigm to an empowerment/collaborative approach requires a new vision of diabetes education and a new definition and enactment of the roles of educators and patients. Our practice is always an expression of our vision; therefore, if our vision is transformed, our practice will most likely change to reflect our vision. Eliminating the concepts of adherence and compliance makes it possible for our patients to discover and actualize their personal responsibility for their diabetes self-management. Also, it helps us to practice diabetes education as win-win collaboration among equals.

Publication types

  • Research Support, U.S. Gov't, P.H.S.
  • Review

MeSH terms

  • Choice Behavior
  • Diabetes Mellitus / psychology*
  • Diabetes Mellitus / rehabilitation*
  • Health Behavior
  • Health Knowledge, Attitudes, Practice*
  • Humans
  • Internal-External Control
  • Models, Educational*
  • Models, Psychological*
  • Patient Advocacy
  • Patient Compliance / psychology*
  • Patient Education as Topic / methods*
  • Patient Participation*
  • Power, Psychological
  • Professional-Patient Relations
  • Self Care / psychology*