Wall Street Journal Offers Practical Compliance Tactics
Taking The Right Pills At The Right Time
In yesterday’s Wall Street Journal Health Journal column, Take Your Medicine: Strategies for Sticking to a Drug Regimen, Tara Parker-Pope takes on the practical problems of medication compliance, focusing on pill organizers, reminders, and a few of the strategies previously discussed in this blog: Picture-cards, Alerting Devices, The Asheville Pharmacist-driven Project, and Pharma-sponsored Compliance Programs.
Commentary
My criticism of this article is - well, that it’s not the article I would have written.1 The time and space restrictions on a columnist are not issues I face posting here. If I skip a day, someone might complain, but I won’t be fired. And, if I am rant-oriented, I can write as many pages if I wish. Ms Parker-Pope does not enjoy such luxuries.
That said, I still believe the columnist’s criteria for usefulness when it comes to compliance methodologies is a tad lax. As the Dodo declares after a race in Alice’s Adventures in Wonderland, “Everybody has won, and all must have prizes.” While one may be able to find instances in which each of the techniques listed made a difference for a given individual or group of individuals, but convincing evidence of overall efficacy is lacking for most.
Interventions to Enhance Medication Adherence in Chronic Medical Conditions: A Systematic Review by Kripalani and colleagues,2 an article referenced in the column, concludes its abstract with a sobering line, “Several types of interventions are effective in improving medication adherence in chronic medical conditions, but few significantly affected clinical outcomes.” I would contend that the column should have emphasized both clauses of that statement rather than focus exclusively on the first.
Footnotes
- If I were to write a single piece for a periodical like the WSJ, I would want to delve into the research, the conceptual basis of compliance, the political and economic implications, … , creating a tome which would displace all other news, columns, and features for weeks. Consequently, the risk to readers is, I suspect, slight. [back]
- Sunil Kripalani, MD, MSc; Xiaomei Yao, MD; R. Brian Haynes, MD, PhD. Interventions to Enhance Medication Adherence in Chronic Medical Conditions: A Systematic Review. Arch Intern Med. 2007;167:540-549 [back]
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