My delay in publishing posts to this blog is, in fact, fairly representative of most episodes of patient noncompliance in that I am uncertain how or why it happened, despite an intense effort to make that determination.

The degree of nonadherence is certainly significant, yet I have found myself repeatedly rationalizing that “one more day” until I made an entry in the blog would be inconsequential.

I am currently dealing with several generic, day-to-day problems, a number of which I could have anticipated and some that appeared without warning or precedent, that require my time and attention. I’ve undergone, for example, a bout of oral surgery, coped with the usual holiday obligations, suffered through the loss of one of the family cars secondary to an accident, managed some unexpectedly complex end-of-the-year financial issues, and begun working on a new project that involves patient compliance. On the other hand, I haven’t a clue how much impact any or all of these have had on my writing.

My declared intent was to write the next post or two on the practical problems involved in using pillboxes and similar compliance aids. On December 3, 2007, the date of my last AlignMap post, I thought I had a handle of the literature that addressed the pragmatics of pillbox use - primarily because that corpus of material was (or so I thought) notably sparse. Within hours of completing that last post, I found that simply substituting another set of search terms expanded the quantity of pertinent literature exponentially by accessing work done in other countries, especially Britain and Australia. This newfound vein of research does require time to read and organize, but when similar issues have come up in the past, I simply announced that one set of posts would be delayed while articles on other topics were published. In this case, however, no notification was given or substitutions made.

Finally, I have been considering dramatically decreasing the frequency of these posts or discontinuing this blog altogether. I’m not convinced that publishing my take on matters of patient compliance has had much impact. The alternative of doing something useful clinically or at least earning a buck or two has become more appealing. But, again, I didn’t do anything about this; I could easily enough, for example, have put a “On Vacation; Back Soon” sign in the blog window.

Which is, I suppose, what I’m doing now. I will follow up on the pillbox problems, primarily because I’m interested in this issue. Once I’ve gone through the research, I’ll post my findings and recommendations.

I’ll also figure out what I want to do about this blog and web site in general.

And for now, I’ll relax a bit and not worry about how many days have gone by since I put words on-line.

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• Semi-Hiatus at AlignMap
• The Misdiagnosed Patient
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• I really cannot understand why it is so difficult to follow directions on the prescription bottle