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Comment & Response
October 9, 2013

Nonadherence to Medications

Author Affiliations
  • 1Behavioural Architects, Oxford, England
JAMA. 2013;310(14):1504. doi:10.1001/jama.2013.277308

To the Editor The Viewpoint by Dr Marcum and colleagues1 outlined the difficulties in identifying medication nonadherence, accurately diagnosing the reasons behind nonadherence, and improving patient adherence. We believe that behavioral science could offer some insights.

First, behavioral science could help to diagnose patient behavior and make sense of what might seem irrational. Of the 6 nonadherence phenotypes identified by the authors, 3 have behavioral causes: the patient’s belief that the costs outweigh the medication benefits, the burden of complex prescriptions, and the patient’s lack of vigilance. In exploring these causes of nonadherence, it is important to acknowledge that much of what influences behavior is subconscious, so conventional qualitative research techniques often provide little insight.