Noncompliance: A Never-Ending Story. Understanding the Perspective of Patients with Rheumatoid Arthritis

  • Maren Stamer Hannover Medical School
  • Norbert Schmacke University of Bremen
  • Petra Richter University for Applied Sciences Kiel
Keywords: (non) compliance, rheumatoid arthritis, patient perspectives, content analysis, grounded theory methodology


For roughly the last 25 years there has been consensus in social science research that the term "compliance" in medical therapy research lacks clarity and may even be counter-productive. However, the medical world continues to be disconcerted and scandalized when patients take a critical attitude to doctors' instructions or indeed fail to comply with them. In order to explore this area, interviews were conducted with patients who have suffered for at least eight to ten years from rheumatoid arthritis, a chronic disease that often leads to disability and a decline in social status. The sample was created in cooperation with the German Rheumatism Research Center (DRFZ) at the Charité Berlin Hospital. The survey methodology comprised partially structured interviews with an initial narrative exploration. The interviews were analyzed both in terms of their content as well as with the use of elements of the framework concept of "grounded theory methodology." Our qualitative study has shown that patients take great efforts to manage their disease and that the important thing here is to provide professional support rather than to criticize patients' individual beliefs, preferences and decisions for or against therapeutic recommendations.



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Author Biographies

Maren Stamer, Hannover Medical School

Maren STAMER is a research associate at the Institute for Epidemiology, Social Medicine and Health Systems Research, Hannover Medical School. Research interests involve qualitative health care research, especially on the interaction and participation in health care services and the topic of interdisciplinary cooperation.

Norbert Schmacke, University of Bremen

Norbert SCHMACKE is a professor of public health at the Institute for Public Health and Nursing, University of Bremen. His research focuses on patient centered medicine.

Petra Richter, University for Applied Sciences Kiel

Petra RICHTER is a research associate at the Institute for Public Health and Nursing, University of Bremen, and lecturer at the Faculty of Social Work and Health, University for Applied Sciences, Kiel. Her research focuses on qualitative social research in the fields of public health and social work.

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