Problems of non-attendance in hand therapy clinics are frequently recorded and linked to poor outcomes in treatment. This paper reviews the therapy and medical literature on compliance, adherence and concordance, and explores ways of gaining the closer involvement and cooperation of patients in their treatment. It suggests that while client-centred approaches and education are important aspects of gaining users’ participation, patients need active encouragement and real opportunities to become involved in health care. Hand therapists need to explore ways in which to negotiate and tailor care to individual client needs.
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