Subscribe to RSS
DOI: 10.1055/a-1241-3433
Compliance von Hunde- und Katzenbesitzern in der Gesundheitsvorsorge
Compliance of dog and cat owners in preventive health care![](https://www.thieme-connect.de/media/10.1055-s-00034911/202005/lookinside/thumbnails/10-1055-a-1241-3433-1.jpg)
Zusammenfassung
Die regelmäßige Gesundheitsvorsorge ist ein wesentlicher Bestandteil der Gesundheit und Lebensqualität unserer Haustiere. Durch Vorsorgeuntersuchungen kann der Entstehung von Krankheiten vorgebeugt werden und bestehende gesundheitliche Probleme lassen sich frühzeitig erkennen und behandeln. Ausschlaggebend für das Erreichen einer optimalen Gesundheitsvorsorge ist, neben der tierärztlichen Beratung, vor allem die Compliance der Besitzer. Hunde- und Katzenbesitzer scheinen sich der Notwendigkeit von Vorsorgeuntersuchungen jedoch oftmals nicht bewusst zu sein, und dies leider häufig infolge einer mangelhaften Kommunikation durch den Tierarzt. Aufklärungsgespräche über die Notwendigkeit regelmäßiger Gesundheitsvorsorgeuntersuchungen sind daher essenziell. Die Kommunikation stellt einen der Schlüsselfaktoren für den Aufbau einer Besitzer-Tierarzt-Beziehung dar. Tierärzte sollten sich ausreichend Zeit für die Kommunikation nehmen, sich ihrer verbalen und nonverbalen Aussagen bewusst sein und Besitzer in Behandlungsentscheidungen einbeziehen. Ältere Tiere werden seltener zur Gesundheitsvorsorge vorgestellt als jüngere Tiere, obwohl in zunehmendem Alter die Prävalenz altersbedingter und chronischer Krankheiten steigt. Daher sollte Besitzern vermittelt werden, dass eine frühzeitige Erkennung und Behandlung dieser Krankheiten die Gesundheit und Lebensdauer ihrer Tiere steigert. Katzenbesitzer stellen ihre Tiere seltener zur Gesundheitsvorsorge vor als Hundebesitzer; vielen von ihnen scheint nicht bewusst zu sein, dass Katzen häufig Krankheitssymptome verbergen. Ein weiterer Grund ist, dass viele Katzen das Einfangen, der Transport und der Besuch in der Praxis stresst. Tierärzte könnten Katzenbesitzer über stressreduzierende Transportmaßnahmen aufklären und ihre Praxis katzenfreundlicher gestalten. Durch geeignetes Praxismanagement, z. B. die Möglichkeit monatlicher Ratenzahlungen, das Anbieten jährlicher Vorsorgepläne sowie eine konsequentere Terminvereinbarung, lässt sich die Compliance ebenfalls positiv beeinflussen. Neben einer verbesserten Tiergesundheit kann dies auch zu einer höheren Zufriedenheit der Besitzer führen.
Abstract
Regular preventive health care is an essential part of our pets’ health and quality of life. Preventive healthcare appointments can result in the prevention of disease development as well as lead to the detection and subsequent treatment of existing health problems at an early stage. In order to achieve optimal health care, the owners’ compliance is of most importance in addition to the veterinary advice. However, dog and cat owners often seem to be unaware of the necessity for preventive health care appointments, often as a result of poor communication by the veterinarian. Educational conversations concerning the necessity of regular preventive health examinations are therefore essential. Communication is one of the key factors in building an owner-veterinarian relationship. Veterinarians are advised to invest sufficient time for communication, be aware of their verbal and non-verbal statements, and enable the owner to participate in treatment decisions. Older animals are presented less often for preventive health care appointments than younger animals, although the prevalence of age-related and chronic diseases increases with age. Owners should therefore be informed on the fact that early detection and treatment of these diseases increases their animals’ health and survival. Cats are seen less frequently in preventive health care than dogs; many owners are not aware of the characteristics of cats tending to hide signs of disease. Another reason lies in the fact that many cats are stressed by being captured and transported in addition to the visit in the veterinary practice itself. Veterinarians therefore should educate cat owners concerning stress-reducing transportation measures and design their practice in a more cat-friendly fashion. Compliance can also be influenced positively by appropriate practice management, such as offering monthly instalment payments, establishing annual preventive care plans, as well as regular re-scheduling strategies. In addition to enhancing the animals’ health, this can also result in increased owner satisfaction.
Publication History
Received: 10 July 2020
Accepted: 17 August 2020
Article published online:
21 October 2020
© 2020. Thieme. All rights reserved.
Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany
-
Literatur
- 1 Klinger C. Analyse des Fallaufkommens in deutschen Tierarztpraxen [Dissertation]. München: Ludwig-Maximilians-Universität; 2016. Im Internet: https://edoc.ub.uni-muenchen.de/20508/1/Klinger_Christoph_Jan.pdf
- 2 Robinson NJ, Brennan ML, Cobb M. et al. Investigating preventive-medicine consultations in first-opinion small-animal practice in the United Kingdom using direct observation. Prev Vet Med 2016; 124: 69-77
- 3 Hill PB, Lo A, Eden CA. et al. Survey of the prevalence, diagnosis and treatment of dermatological conditions in small animals in general practice. Vet Rec 2006; 158: 533-539
- 4 Day MJ, Horzinek MC, Schultz RD. et al. WSAVA Guidelines for the vaccination of dogs and cats. J Small Anim Pract 2016; 57: E1-E45
- 5 American Animal Hospital Association – American Veterinary Medical Association Preventive Healthcare Guidelines Task Force. Development of new canine and feline preventive healthcare guidelines designed to improve pet health. J Am Anim Hosp Assoc 2011; 47: 306-311 doi:10.5326/jaaha-ms-4007
- 6 Hoyumpa Vogt A, Rodan I, Brown M. et al. AAFP-AAHA: feline life stage guidelines. J Feline Med Surg 2010; 12: 43-54
- 7 Creevy KE, Grady J, Little SE. et al. 2019 AAHA canine life stage guidelines. J Am Anim Hosp Assoc 2019; 55: 267-290
- 8 Baralon P. Verbesserung der Compliance in der Präventivmedizin. vetfocus 2012; 22: 23-28 doi:10.1055/s-0034–1381873
- 9 Diez M, Picavet P, Ricci R. et al. Health screening to identify opportunities to improve preventive medicine in cats and dogs. J Small Anim Pract 2015; 56: 463-469
- 10 Davies M. Geriatric screening in first opinion practice – results from 45 dogs. J Small Anim Pract 2012; 53: 507-513
- 11 Wayner CJ, Heinke ML. Compliance: crafting quality care. Vet Clin North Am Small Anim Pract 2006; 36: 419-436
- 12 American Animal Hospital Association. The path to high-quality care – practical tips for improving compliance. Lakewood, CO, USA: AAHA Press; 2003
- 13 Casey RA, Bradshaw JW. Owner compliance and clinical outcome measures for domestic cats undergoing clinical behavior therapy. J Vet Behav 2008; 3: 114-124
- 14 Lavan RP, Tunceli K, Zhang D. et al. Assessment of dog owner adherence to veterinarians‘ flea and tick prevention recommendations in the United States using a cross-sectional survey. Parasit Vectors 2017; 10: 284
- 15 Vetline – Schlütersche Verlagsgesellschaft mbH & Co. KG. Die Crux mit der Compliance (13.07.2005). https://vetline.de/compliance/150/3105/66629 Stand: 06.05.2020
- 16 Alhewiti A. Adherence to long-term therapies and beliefs about medications. Int J Family Med 2014; 2014: 479596
- 17 Gorenoi V, Schönermark MP, Hagen A. Schriftenreihe Health Technology Assessment (HTA) in der Bundesrepublik Deutschland. Maßnahmen zur Verbesserung der Compliance bzw. Adherence in der Arzneimitteltherapie mit Hinblick auf den Therapieerfolg (2007). http://portal.dimdi.de/de/hta/hta_berichte/hta206_bericht_de.pdf Stand: 06.05.2020
- 18 World Health Organization. Adherence to long-term therapies. Evidence for action (2003). https://www.who.int/chp/knowledge/publications/adherence_full_report.pdf Stand: 06.05.2020
- 19 Seemann U, Kissling W. Volkskrankheit „Noncompliance”– Ursachen, Folgen, Therapiemöglichkeiten. Psychoneuro 2008; 34: 405-409
- 20 Volk JO, Felsted KE, Thomas JG. et al. Executive summary of phase 2 of the Bayer veterinary care usage study. J Am Vet Med Assoc 2011; 239: 1311-1316
- 21 Volk JO, Felsted KE, Thomas JG. et al. Executive summary of the Bayer veterinary care usage study. J Am Vet Med Assoc 2011; 238: 1275-1282
- 22 Volk JO, Thomas JG, Colleran EJ. et al. Executive summary of phase 3 of the Bayer veterinary care usage study. J Am Vet Med Assoc 2014; 244: 799-802
- 23 Lue TW, Pantenburg DP, Crawford PM. Impact of the owner-pet and client-veterinarian bond on the care that pets receive. J Am Vet Med Assoc 2008; 232: 531-540
- 24 Foot H, La Caze A, Gujral G. et al. The necessity-concerns framework predicts adherence to medication in multiple illness conditions: a meta-analysis. Patient Educ Couns 2016; 99: 706-717
- 25 Belshaw Z, Robinson NJ, Dean RS. et al. Motivators and barriers for dog and cat owners and veterinary surgeons in the United Kingdom to using preventative medicines. Prev Vet Med 2018; 154: 95-101
- 26 Eschle S, Hartmann K, Rieger A. et al. Canine vaccination in Germany: A survey of owner attitudes and compliance. PLoS One 2020; 15: e0238371
- 27 Banfield Pet Hospital. State of Pet Health 2013 Report (2013). https://www.banfield.com/Banfield/media/PDF/Downloads/soph/Banfield-State-of-Pet-Health-Report_2013.pdf Stand: 08.07.2020
- 28 Egenvall A, Nodtvedt A, Haggstrom J. et al. Mortality of life-insured Swedish cats during 1999–2006: age, breed, sex, and diagnosis. J Vet Intern Med 2009; 23: 1175-1183
- 29 Statistisches Bundesamt. Lebenserwartung von Männern und Frauen bei der Geburt in Deutschland im Zeitraum der Jahre 1871 bis 2018 (in Jahren) (05.11.2019). https://de.statista.com/statistik/daten/studie/185394/umfrage/entwicklung-der-lebenserwartung-nach-geschlecht/ Stand: 12.05.2020
- 30 Kim E, Choe C, Yoo JG. et al. Major medical causes by breed and life stage for dogs presented at veterinary clinics in the Republic of Korea: a survey of electronic medical records. Peer J 2018; 6: e5161
- 31 Zolnierek KB, Dimatteo MR. Physician communication and patient adherence to treatment: a meta-analysis. Med Care 2009; 47: 826-834
- 32 Maille V, Hoffmann J. Compliance with veterinary prescriptions: the role of physical and social risk revisited. J Bus Res 2013; 66: 141-144
- 33 Shaw JR, Adams CL, Bonnett BN. What can veterinarians learn from studies of physician-patient communication about veterinarian-client-patient communication?. J Am Vet Med Assoc 2004; 224: 676-684
- 34 Bentlage G. Verbesserung der Compliance durch gelungene Kommunikation. In: Bentlage G. Hrsg. KommunikationsSkills. 1. Aufl.. Stuttgart: Schattauer GmbH; 2016.
- 35 Roter D, Hall JA. Doctors Talking with Patients/Patients Talking with Doctors: Improving Communication in Medical Visits. 2nd ed.. Westport: Greenwood Publishing Group; 2006.
- 36 Brown BR. The dimensions of pet-owner loyalty and the relationship with communication, trust, commitment and perceived value. Vet Sci 2018; 5 (04) 95
- 37 Shaw JR, Bonnett BN, Adams CL. et al. Veterinarian-client-patient communication patterns used during clinical appointments in companion animal practice. J Am Vet Med Assoc 2006; 228: 714-721
- 38 Cornell KK, Kopcha M. Client-veterinarian communication: skills for client centered dialogue and shared decision making. Vet Clin North Am Small Anim Pract 2007; 37: 37-47
- 39 Kanji N, Coe JB, Adams CL. et al. Effect of veterinarian-client-patient interactions on client adherence to dentistry and surgery recommendations in companion-animal practice. J Am Vet Med Assoc 2012; 240: 427-436
- 40 Shaw JR, Adams CL, Bonnett BN. et al. Veterinarian-client-patient communication during wellness appointments versus appointments related to a health problem in companion animal practice. J Am Vet Med Assoc 2008; 233: 1576-1586
- 41 Robinson NJ, Brennan ML, Cobb M. et al. Capturing the complexity of first opinion small animal consultations using direct observation. Vet Rec 2015; 176: 48
- 42 Robinson NJ, Dean RS, Cobb M. et al. Consultation length in first opinion small animal practice. Vet Rec 2014; 175: 486
- 43 Belshaw Z, Robinson NJ, Dean RS. et al. „I always feel like I have to rush…“ pet owner and small animal veterinary surgeons‘ reflections on time during preventative healthcare consultations in the United Kingdom. Vet Sci 2018; 5: 20
- 44 Belshaw Z, Robinson NJ, Brennan ML. et al. Developing practical recommendations for preventative healthcare consultations involving dogs and cats using a Delphi technique. Vet Rec 2019; 184: 348
- 45 Schaeffer D, Vogt D, Berens EM. et al. Gesundheitskompetenz der Bevölkerung in Deutschland: Ergebnisbericht (Dezember 2016). https://pub.uni-bielefeld.de/record/2908111 Stand: 08.07.2020
- 46 Cosic F, Kimmel L, Edwards E. Patient comprehension of common orthopedic terminology. Health Lit Res Pract 2019; 3: e187-e193
- 47 Abood SK. Increasing adherence in practice: making your clients partners in care. Vet Clin North Am Small Anim Pract 2007; 37: 151-164 doi:10.1016/j.cvsm.2006.09.011
- 48 Blättner A. Nonverbale Kommunikation in der Praxis. Teamkonkret 2011; 7: 104-105
- 49 Blättner A, Matzner W. Die gesunde Tierarztpraxis – Marketing und Kommunikation. 1. Aufl.. Stuttgart: Enke; 2010
- 50 Benbenishty JS, Hannink JR. Non-verbal communication to restore patient-provider trust. Intensive Care Med 2015; 41: 1359-1360
- 51 Carson CA. Nonverbal communication in veterinary practice. Vet Clin North Am Small Anim Pract 2007; 37: 49-63
- 52 Henry SG, Fuhrel-Forbis A, Rogers MA. et al. Association between nonverbal communication during clinical interactions and outcomes: a systematic review and meta-analysis. Patient Educ Couns 2012; 86: 297-315
- 53 Cruz M, Roter DL, Cruz RF. et al. Appointment length, psychiatrists‘ communication behaviors, and medication management appointment adherence. Psychiatr Serv 2013; 64: 886-892
- 54 Gehrig AC, Hartmann K, Gunther F. et al. A survey of vaccine history in German cats and owners‘ attitudes to vaccination. J Feline Med Surg 2019; 21: 73-83
- 55 Rodan I, Sparkes AH. Preventive health care for cats. The Cat 2012; 1: 151-180
- 56 American Association of Feline Practitioners. Cat Friendly Practices® (2012). https://catvets.com/cfp/cfp Stand: 08.07.2020
- 57 Gerrard E. Owner compliance-educating clients to act on pet care advice (21.04.2015). https://www.vettimes.co.uk/app/uploads/wp-post-to-pdf-enhanced-cache/1/owner-compliance-educating-clients-to-act-on-pet-care-advice.pdf Stand: 08.07.2020.
- 58 Robinson NJ, Belshaw Z, Brennan ML. et al. Topics discussed, examinations performed and strategies implemented during canine and feline booster vaccination consultations. Vet Rec 2019; 184: 252
- 59 Royal KD, Katie Sheats M, Kedrowicz AA. Readability evaluations of veterinary client handouts and implications for patient care. Top Companion Anim Med 2018; 33: 58-61
- 60 European Scientific Counsel Companion Animal Parasites. Servicematerial (15.05.2020). https://www.esccap.de/tieraerzte/servicematerial/ Stand: 08.07.2020
- 61 Jacobson Vann JC, Jacobson RM, Coyne-Beasley T. et al. Patient reminder and recall interventions to improve immunization rates. Cochrane Database Syst Rev 2018; 1: Cd003941
- 62 Adams VJ, Waldner CL, Campbell JR. Analysis of a practice management computer software program for owner compliance with recall reminders. Can Vet J 2006; 47: 234-240
- 63 Gerrard E. Worming – sending reminders and maintaining compliance (01.08.2012). https://www.vettimes.co.uk/app/uploads/wp-post-to-pdf-enhanced-cache/1/worming-sending-reminders-and-maintaining-compliance.pdf Stand: 08.07.2020
- 64 Goulding J. Ins and outs of implementing a pet health plan. In Pract 2011; 33 (Suppl. 08) 410-412
- 65 The Pet Health Club. Routine healthcare plans for pets (2020). https://www.thepethealthclub.co.uk/ Stand: 30.04.2020
- 66 Moriarty L. Implementing successful pet health plans in practice. In Pract 2019; 41: 227-229
- 67 Ravetz G. Prevention is better than cure: promoting pet health plans. Veterinary Business Journal 2017; 170: 16-19
- 68 Moran M. Do health plans work?. In Pract 2015; 37: 42-45
- 69 YouGov, People‘s dispensary for sick animals. PAW PDSA animal wellbeing Report (2019). https://www.pdsa.org.uk/media/7420/2019-paw-report_downloadable.pdf Stand: 06.06.2020
- 70 Habacher G, Gruffydd-Jones T, Murray J. Use of a web-based questionnaire to explore cat owners‘ attitudes towards vaccination in cats. Vet Rec 2010; 167: 122-127
- 71 Association of British Insurers. Pet insurance policy exclusions. https://www.abi.org.uk/products-and-issues/choosing-the-right-insurance/pet-insurance-guide/common-exclusions/ Stand: 06.06.2020
- 72 Wilson IB, Rogers WH, Chang H. et al. Cost-related skipping of medications and other treatments among Medicare beneficiaries between 1998 and 2000. Results of a national study. J Gen Intern Med 2005; 20: 715-720
- 73 Piette JD, Heisler M, Krein S. et al. The role of patient-physician trust in moderating medication nonadherence due to cost pressures. Arch Intern Med 2005; 165: 1749-1755
- 74 Coe JB, Adams CL, Bonnett BN. A focus group study of veterinarians‘ and pet owners‘ perceptions of the monetary aspects of veterinary care. J Am Vet Med Assoc 2007; 231: 1510-1518
- 75 Industrieverband Heimtierbedarf (IVH) e. V.. In jedem dritten Haushalt lebt ein Tier – Hunde und Katzen besonders beliebt (14.04.2008). https://www.ivh-online.de/de/presse-medien/archiv.html Stand: 01.07.2020