In the past week, The New York Times has published two articles that deal directly with patient compliance.
1. In today’s edition, Motivation: For Patients, There’s Beauty in the Ugly Truth by Nicholas Bakalar summarizes Visualizing coronary calcium is associated with improvements in adherence to statin therapy by Kalia, Miller, et al (Atherosclerosis. 2006 Apr;185(2):394-9. Epub 2005 Jul 26.) ~Abstract~
According to the Times the study “suggests that when patients see a scan showing plaque accumulation in their own arteries, their adherence to a lipid-lowering drug regimen increases significantly.” The newspaper article did not note that adherence was calculated from the patients’ self-report via questionnaires, a methodology which some hold to be unreliable.
Given the lack of response to analogous efforts in other fields (e.g., using specimens of diseased lungs to motivate smokers to quit), I am surprised by the results. Further, from my experience with patients it seems clear that motivation to recover is not synonymous with motivation to comply with treatment (See Myth #3: Noncompliance Can Be Eliminated By Educating The Patient, Motivating The Patient, Eradicating Or Relieving Side-effects, Simplifying The Treatment Plan, …).
In any case, I would be more swayed if adherence had been assessed by other methodologies (e.g., direct observation, pill counts, correlation with clinical changes) in addition to the patients’ self-report.
2. Just What the Doctor Ordered? Not Exactly by Jane E. Brody, published on 9 May 2006, discusses some of the possible causes of noncompliance, including misunderstanding of instructions, cultural barriers, impracticality, and failure to complete a course of treatment after symptoms disappear.
Links to these articles and many more can be found at the AlignMap Furl Archive (also accessible at the Resources tab).