Surveys have shown that 15 – 30% of the time, patients don’t even bother to fill a prescription their doctor has given them.

And that’s only the beginning of the problem of drug compliance.  There’s another large group that fills their prescription, but doesn’t ever take the pills, or doesn’t take the prescribed amount.  More than 75% of adults surveyed admitted that they didn’t entirely follow their doctor’s recommendations.

What’s responsible for the big drug gap?

Some of the reasons why people don’t take their medicine include

• Concern about the cost
• Poor provider communication
• Burdensome treatment regimens
• Mental illness or depression contributing to poor compliance
• The possibility of side-effects, and
• Personal beliefs about the value of medication

Interestingly, compliance with a doctor’s medication recommendations does not correlate with socioeconomic status or educational level.

The Big Four

Health policy experts look at these numbers and find huge room for improvement.  If drug compliance could be improved, they reason, the nation’s health would improve too.  And we’d save money in the long run. Because it’s better to control your chronic high blood pressure (for example) than to increase your risk of a serious heart attack down the road.

What’s Wrong With This Analysis?

I’m entirely in favor of people taking the prescription drugs that they need.

If you have any concerns about the efficacy or safety (or cost!) of any of the drugs you’re taking, I urge you to ask questions of your doctor. Or develop a relationship with a good pharmacist.  Don’t just side-step your recommended medications without becoming better informed.  Used appropriately, prescription drugs can be a powerful force to maintain health.

But if policy-shapers are worrying about whether Americans are taking their drugs or not, they’re missing the larger picture.  No one gets high cholesterol because of a Lipitor deficiency.  Nor are we depressed because there’s too little Prozac in our blood stream.  Oftentimes patients avoid drugs because they’re concerned with possible side-effects or believe there may be safer, more natural alternatives.

There are no drugs without side-effects.  Admittedly, sometimes their benefits outweigh the negatives.  But drugs don’t get at the root of these four big chronic conditions.

Yet there are powerful, effective, inexpensive non-drug treatments that do.  Here are two examples.

This is a list of three well-researched methods to improve blood pressure and reduce the risk of cardiovascular disease:

• Better balanced intake of essential fatty acids
• Chiropractic adjustments
• Regular moderate exercise

Here are four methods to help dispel depression:

• Go out for a 20 minute walk
• Pet your cat
• Visit your grandmother 
• Volunteer to help teach children to read

Get the picture?  See any need for a prescription pad here?

These are the strategies that our health policy-makers should be focusing on.

Dr. Lavine has been an innovator in the use of movement and touch to promote health since 1981. He practices in New York City and Princeton, NJ.

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Surprise! Surprise! Pharmaceutical companies have an undue influence on medical practice