Education And Debate

Personal paper: writing prescriptions is easy

BMJ 1997; 314 doi: http://dx.doi.org/10.1136/bmj.314.7082.747 (Published 08 March 1997) Cite this as: BMJ 1997;314:747
  1. Marshall Marinker, visiting professor of general practicea
  1. a United Medical and Dental Schools of Guy's and St Thomas's Hospitals London SE1 7EH
  • Accepted 13 February 1997

Introduction

To write prescriptions is easy, but to come to an understanding of people is hard.

Franz Kafka, A Country Doctor

Only about 50% of patients with chronic diseases take their medicines in therapeutically effective doses.1 Although the cost of non-compliance in illness and premature death is staggering, the issue has been neglected in the debates on healthcare resources and rationing. This week a working party of the Royal Pharmaceutical Society of Great Britain publishes its report on medicine taking.2 It was set up to consider the scale and consequences of non-compliance and to make recommendations. Many of our group, which was made up of doctors, pharmacists, nurses, and social scientists, admitted early on that we rarely took medicines as prescribed. Some confessed to abandoning courses of antibiotics after the first day or two. After we reviewed published work it became apparent that non-compliance might be no more deviant behaviour …

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