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Abstract
<p class="first" id="d1515762e57">A large quantity of research concerning issues of
patient compliance with medications
has been produced in recent years. The assumption in much of this work is that patients
have little option but to comply with the advice and instructions they receive. Studies
have shown, however, that between one third and one half of all patients are non-compliant,
but different authors cite different reasons for this high level of non-compliance.
In this paper, the concept of compliance is questioned. It is shown to be largely
irrelevant to patients who carry out a 'cost-benefit' analysis of each treatment,
weighing up the costs/risks of each treatment against the benefits as they perceive
them. Their perceptions and the personal and social circumstances within which they
live are shown to be crucial to their decision-making. Thus an apparently irrational
act of non-compliance (from the doctor's point of view) may be a very rational action
when seen from the patient's point of view. The solution to the waste of resources
inherent in non-compliance lies not in attempting to increase patient compliance per
se, but in the development of more open, co-operative doctor-patient relationships.
</p>