Have there been any studies on the rate of patient compliance with drug regimens prescribed by their clinicians?
—Felix N. Chien, DO, Newport Beach, Calif.

You see it every day—the medication you prescribed, say an antihypertensive or a lipid-lowering agent, has not achieved the desired effect. You ramp up the dose, but is your patient taking the medicine as you prescribed it? A study by Haynes et al suggests that about half the medicines prescribed for patients with long-term conditions are not taken as prescribed (Lancet. 1996;348:383-386). “Noncompliance” is a tremendous public-health problem affecting all ages and ethnic groups. It may be intentional or involuntary, is clearly multifactorial, and does not have a simple solution. In a review of interventions to help with patient compliance, Haynes et al looked at many methods, none of which had great success. As clinicians, we can start to address this issue by doing our best to form a relationship characterized by mutual respect and a strong therapeutic alliance and by making sure we have the same goals of therapy as our patients.
—Susan Kashaf, MD, MPH (121-12)