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tvpjournal.com | september/october 2015 | Today's VeTerinary PracTice aHs HearTWorM HoTLine Peer reviewed 77 percentage of cats are estimated to be receiving a heartworm preventive. 4 Within the Practice estimates from national organizations are helpful in understanding compliance trends, but the data that matter most to veterinarians in practice are those from their own clients. individual veterinarians may not be able to change the overall trajectory of HWd, but they can address compliance in their own practices. Tracking purchase history is a reliable means of determining a pet owner's compliance, especially when paired with client dialogue. in my own practice, before i walk into the examination room, a staff member has handed me the data on the client's heartworm prevention purchases. This helps facilitate a truthful and productive discussion with the client and also serves as a good reminder to discuss heartworm prevention with the client. EFFECTS OF NONCOMPLIANCE When considering HWd, the effects of heartworm preventive noncompliance are clear: in dogs, cats, and even ferrets, the risk of developing HWd, which can be fatal, is greatly increased, and in the case of cats and ferrets, there are no approved medications for treatment of HWd. an additional downside to preventive noncompliance is the cost differential between prevention and treatment, should the pet contract heartworms. 6 not only is the annual cost of prevention typically less than 10% of the cost of heartworm treatment, but damage from HWd is often permanent, even when treatment is administered. Furthermore, treatment often produces painful infammation at the injection site, it is far from perfect in its effcacy, and eliminating heartworms can, and does, worsen pulmonary disease associated with heartworm infection. STRATEGIES FOR COMPLIANCE SUCCESS Human Medicine an extensive study of factors affecting therapeutic compliance with human medications revealed that the compliance rate of long-term medication therapies was between 40% and 50%, dropping to 20% to 30% when a lifestyle change was required in addition to medication. 6 demographic factors, such as age, gender, and education level of human patients, were variable in their effect on compliance; more predictable factors affecting compliance success included: • Feeling susceptible to the illness or its complications • Understanding that the illness or its complications could have severe health consequences • Believing the therapy would be effective or perceiving benefit from the therapy. 6 Veterinary Medicine if these factors are applied to the scenario of veterinary clients and heartworm compliance, it is clear that similar principles are in play. Many practitioners believe the biggest obstacle is not the cost of preventives; rather, the culprit is the owner's perception regarding the need for prevention. • clients whose pets are not on heartworm preventives often don't understand the need and the urgency for heartworm prevention. tvpjournal.com | september/october 2015