Daily regimen and compliance with treatment

doi:10.1136/bmj.323.7314.647

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Fewer daily doses and drugs with fewer side effects improve compliance

Bernard S Bloom, research professor (bsbloom@mail.med.upenn.edu)

Department of Medicine, University of Pennsylvania, Philadelphia, PA 19104-2676, USA

Patient compliance—that is, adherence to the regimen of care recommended by the doctor and persistence with it over time—has been a common concern in medical practice for a long time. A search on Medline found nearly 60 000 citations since 1980 related to compliance. Though much is known about the problem and how to overcome it, little seems to have been done in everyday medical practice by healthcare systems and practitioners.

At most, 50% of people with chronic disease comply with their doctor's recommendations, irrespective of disease, treatment, or age.1 Adherence and persistence are poor even among patients with diseases with a high and moderate risk of death.2-4 Many factors related to patients, doctors, and the medical system affect compliance with treatment.2-7 Similar problems exist in all countries. 5 6 Doctors and patients are equally responsible for this abysmal state of affairs.5

The disease …