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Comment & Response
April 23/30, 2014

Strategies to Overcome Medication Nonadherence

Author Affiliations
  • 1Express Scripts Holding Company, St Louis, Missouri
JAMA. 2014;311(16):1693. doi:10.1001/jama.2014.1760

To the Editor The suggestions by Dr Zullig and colleagues1 for improving medication adherence are laudable, but we believe their list of barriers to nonadherence overlooks 2 fundamental features of human behavior, inattention and inertia, while overemphasizing the need for engagement.

Human attention is both scarce and fragile, with most behaviors occurring automatically rather than being deliberate and overt.24 Humans devote their attention to that which is either pleasing or pressing; thus, things that do not immediately demand attention may not receive it. Because many behaviors are important over the long-term but not immediately pressing, inattention often leads to inertia, which creates a gap between good intentions (more exercise, better diet, taking medications as prescribed) and action.

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