The first step in attacking the compliance problem is improving physician awareness, experts say. Instead, patients face a number of barriers when they leave the physician's office. Some are unable even to read a doctor's orders, for instance, and cultural issues such as dietary restrictions may prevent them from following through. The main obstacle for some patients is the cost of the prescribed treatment, especially if they are uninsured, Dr. Avorn says. On the other hand, studies have found high noncompliance among patients with good coverage, indicating that cost is not the only issue.
Communication is another major factor.
Many patients simply do not understand their prescribed course of treatment. When physicians fail to warn patients about potential problems, patients often use those complications as a reason to quit taking the medicine, he says. On the other hand, patients also use positive outcomes as a reason to discontinue their therapy, says Dr. Ferdman. People still treat asthma as an episodic disease. And they forget to do preventive tasks once they are feeling better.