Poor compliance: The hidden risk factor
Poor compliance with prescribed regimens remains a potent barrier to good outcomes in coronary heart disease and other chronic diseases. Such poor compliance is related to disease, patient, provider, and treatment factors and has yet to be fully understood. In general, the less complex the regimen, the better informed the patient and the physician, and the more serious the disease, the better the compliance.
That said, research information on compliance has been somewhat stagnant for several years. There have been very few new approaches that have broken new ground or significantly enhanced or altered correct approaches. It is probably necessary that future research involve nonmedical disciplines including motivational psychology and even advertising. A good deal of such research should be specifically directed toward improving compliance in asymptomatic patients who are nevertheless at substantial risk of future catastrophic events. Until we are more successful at reproducibly improving compliance in high-risk, but asymptomatic, patients, the potential benefits of regimens whose efficacy is already very clear will remain unfulfilled.
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