Elsevier

The Lancet

Volume 342, Issue 8876, 9 October 1993, Pages 909-913
The Lancet

Review articles
Non-compliance—or how many aunts has Matilda?

https://doi.org/10.1016/0140-6736(93)91951-HGet rights and content

Abstract

The compliance of patients with medication prescribed for them is a challenge. It seems that one-third of patients comply adequately, one-third more-or-less, and one-third are non-compliant, so that compliance rates hover around 50%. This can be improved upon, but not by treating failure to comply as a deplorably aberrant behaviour. First we need to know more about compliance and non-compliance, and that means standardising methods of study and measuring, by questioning the patient, counting tablets, or looking at drug metabolites or markers in faeces, blood or urine. Doctors' prejudices and patients' perceptions alike have to be taken into account since strategies for improvement must include both educating the prescriber and counselling the patient.

References (49)

  • Wm Dixon et al.

    Outpatient PAS therapy

    Lancet

    (1957)
  • T. Pullar et al.

    Problems of compliance with drug treatment: new solutions?

    Pharm J

    (1990)
  • Bj Stephenson et al.

    Is this patient taking the treatment as prescribed?

    JAMA

    (1993)
  • Ws Bond et al.

    Detection methods and strategies for improving medication compliance

    Am J Hosp Pharm

    (1991)
  • J. Trostle

    Doctors' orders and patients' self-interest: two views of medication usage?

    Compliance Epilepsy

    (1988)
  • Rb Haynes et al.

    Compliance in health care

    (1979)
  • D. Haefner et al.

    Motivational and behavioral effects of modifying health beliefs

    Publ Health Rep

    (1970)
  • D. Schwartz et al.

    Medication errors made by elderly, chronically ill patients

    Am J Publ Health

    (1962)
    Mh Becker et al.

    Sociobehavioral determinants of compliance with health and medical care recommendations

    Med Care

    (1975)
  • Dl Sackett et al.

    The magnitude of compliance and non-compliance

  • P. Rudd et al.

    The natural history of medication compliance in a drug trial: limitations of pill counts

    Clin Pharm Therapy

    (1989)
  • Tme Davis et al.

    Compliance in diabetes mellitus: a self-assessment study

    Practical Diabetes

    (1988)
  • Ab Bergsman et al.

    Failure of children to receive penicillin by mouth

    N Engl J Med

    (1963)
  • L. Gordis et al.

    The inaccuracy in using interviews to estimate patient reliability in taking medications at home

    Med Can

    (1969)
  • Ga Ellard et al.

    The application of urine tests to monitor the regularity of dapsone self-administration

    Lepr Rev

    (1974)
  • Rb Haynes et al.

    Can simple clinical measurements detect patient noncompliance?

    Hypertension

    (1980)
  • Hp Roth et al.

    Measuring intake of a prescribed medication: A bottle count and a tracer technique compared

    Clin Pharmacol Ther

    (1970)
  • T. Pullar et al.

    Time to stop counting the tablets?

    Clin Pharmacol Ther

    (1989)
  • Rd Yee et al.

    Medication monitor for ophthalmology

    Am J Ophthalmol

    (1974)
  • Gl Hobby et al.

    The use of riboflavin as an indicator of isoniazid ingestion in self-medicated patients

    Am Rev Resp Dis

    (1959)
  • Ga Ellard et al.

    An evaluation of the potential use of isoniazid, acetylisoniazid and isonicotinic acid for monitoring the self-administration of drugs

    Br J Clin Pharmacol

    (1980)
  • Ja Cramer et al.

    How often is medication taken as prescribed?

    JAMA

    (1989)
  • Ms Davis

    Variations in patients' compliance with doctors' orders: Analysis of congruence between survey responses and results of empirical investigations

    J Med Educ

    (1968)
  • Jm Mazzulo et al.

    Take thou... but is your patient really taking what you prescribed?

    Drug Ther

    (1972)
  • Vt Nagy et al.

    Cognitive predictors of compliance in chronic disease patients

    Med Care

    (1984)
  • Cited by (0)

    View full text