Health Care Delivery

Chronic disease patients who complain to their doctors about their medications are twice as likely to stop taking them

Patients who have a chronic disease such as hypertension, diabetes, or heart disease typically must take several medications to manage their condition. These medications can be costly, and they may have disturbing side effects. In fact, one of every five chronic disease patients complained to his or her primary care doctor about a medication during the 1980s, according to a study supported by the Agency for Healthcare Research and Quality (HS08431).

Complaints ranged from medication cost and side effects to not liking the medication or feeling that it was not working. Complaining patients were twice as likely not to comply with their medication regimens (fail to take it or be confused about how to take it) as patients who did not complain.

Nearly half of the time (45 percent), doctors changed the patient's medication in response to complaints or adherence problems. However, doctors did nothing in response to 27 percent of patients who complained about their medication(s) and 33 percent of patients who said they were having trouble complying with their medication regimen. The authors suggest that this inattention to patient complaints may have stemmed from physicians' unsuccessful efforts to deal with medication problems during previous medical encounters with the patients.

More research is needed on how to improve the ways doctors respond to patients' medication complaints and adherence problems. Also, policies are needed that will give doctors adequate time to explore patients' attitudes about their medications and modify medication regimens to make them acceptable to both patients and providers, concludes Betsy Sleath, Ph.D., of the University of North Carolina at Chapel Hill. Study findings are drawn from 503 audiotaped physician interactions with adult chronic disease patients in the mid-1980s at outpatient settings in 11 U.S. and Canadian communities.

See "Patient expression of complaints and adherence problems with medications during chronic disease medical visits," by Dr. Sleath, Betty Chewning, Ph.D., Bonnie Svarstad, Ph.D., and Debra Roter, Dr.P.H., in the Summer 2000 Journal of Social and Administrative Pharmacy 2, pp. 71-80.

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