Newsletter

(Non-)Compliance with Treatment2024-10-28

Treatment non-compliance is a big problem in medicine in general, and in psychiatry in particular, that reduces the effectiveness of what we do, over and above the other limitations the field has. Paying attention to and mitigating this issue can lead to much improved health outcomes. What are the root causes?

First, people may have side-effects or decreased quality of life from the prescribed treatment. This is quite common, for some of the most prescribed medications, from statins in medicine to SSRIs in psychiatry. The solution is to prescribe minimal amounts, and make sure diagnostically and pathophysiologically, with laboratory tests, that the medication is needed and that it works in the first place.

Second, people consciously or unconsciously resent being dependent on an external factor, in this case a medication, especially if it is viewed as imposed on them by an external authority whom they do not particularly trust. The solution is transparency and joint decision-making, where the problems and options are being discussed with the person, and they decide what they wish to do. Then it is their decision, so they comply with that.

Third, people may feel an issue they are treated for is not that big of a problem for them personally, or that it has resolved, and that they do not need to be on or continue treatment for it. The solution is to provide them with objective information such as laboratory tests (for example, see our bloodtests), explain the risks of not treating and the benefits of treatment and prevention.

The medicine, and psychiatry, of the future are Precise, Personalized, Preventive, and Participatory! My teams have been working hard to empower that.