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Prescribing Advice for GPs

An NHS Prescribing Advisers' Blog

Consider Compliance in Treatment Failure

The Daily Telegraph carried a story today detailing the findings of a study of 20,000 diabetics that found up to two thirds of patients were putting their health at risk by not taking their medication correctly.

This is of great concern but is not something new, the Medicines Partnership considered compliance for a wide range of conditions and produced a report on October 2003. In this report there are references1 that estimate that 50% of patients with coronary heart disease stop taking their cholesterol lowering therapy within a year and this increases to 85% in the second year. Similarly, at the end of the West of Scotland Coronary Prevention study2 (WOSCOPS) participants found that a quarter of them were classed as non compliant at five years.

This latest study adds to the growing evidence that patients' compliance with their medicines is not as expected.

Action: Compliance (or lack of it) should be a primary consideration in any treatment failure. Many cases of treatment failure could be attributable to poor compliance with prescribed therapies; drugs cannot work if they are not taken. Reasons for poor compliance should be explored with the patient before considering changes or additions to treatment.


  1. The problems of compliance to cholesterol altering therapy. Insull W, Journal of Internal Medicine;241:317-325.
  2. Prevention of coronary heart disease with pravastatin in men with hypercholesterolaemia. Shepard J et al, New England Journal of Medicine;333:1301-1307.

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