Medication Compliance Research Review

11-17-2006 | Categories:

Medication Compliance Research: Still So Far to Go Albert I. Wertheimer, Thomas M. Santella Journal of Applied Research in Clinical and Experimental Therapeutics 2003; 3(3): 254-261.



The authors have compiled the compliance research, dividing it into six categories:

  1. Articles identifying adherence as a problem
  2. Articles identifying the causes of noncompliance & exploring solutions
  3. Articles analyzing adherence with respect to specific ailments
  4. Articles exploring the patient’s role with respect to compliance
  5. Articles exploring the pharmacist’s role with respect to compliance
  6. Articles exploring the physician’s role with respect to compliance

The bulk of this article deals with the prevalence, incidence, and costs of noncompliance; examples of the compliance enhancements currently available; the theoretical models of medication compliance; and the incapacity of the healthcare professions to effect positive changes.

The conclusions are disheartening.

… one can only conclude that there is still no real consensus concerning the most effective way to improve patient compliance. The research shows that adherence to medications is not routinely measured in clinical practice and a universal standard that can easily be implemented does not exist

The final recommendation is limited to

… perhaps it is reasonable to shift our focuses to the other side of the patient diad: the practitioner. From the literature, we know that the there exists an almost overwhelming amount of information on ways for physicians to improve compliance through establishing better communication techniques. We also know that among the many different communication techniques proposed, none clearly stands out as a clear method for improving patient compliance consistently. We know that the more time physicians give to improving their patients’ compliance, the more effective their efforts are. We know that an increase in the role of the pharmacist improves compliance. We know that telephone and mail-card reminders alone show no real significant improvement in patient compliance.


Commentary

This article is useful as a survey, but its categorization of articles seems arbitrary and of minimal utility. Similarly, the recommendation that research focus on the clinician is followed not by an explanation or support but by confessions that previous studies provide little direction for this tack.


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