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June 17, 1974

Diagnosis and Management of Patient Noncompliance

Author Affiliations

From the National Center for Health Services, Research and Development, Rockville, Md. Dr. Gillum is now with the National Heart and Lung Institute, Bethesda, Md. Dr. Barsky is now with the Department of Psychiatry, Massachusetts General Hospital, Boston.

JAMA. 1974;228(12):1563-1567. doi:10.1001/jama.1974.03230370045023

Patient noncompliance with medical regimens is one of the major unsolved therapeutic problems confronting the medical profession today. Physicians have great difficulty identifying and dealing with noncompliers. A critical review of the literature has disclosed that the factors most consistently related to noncompliance are (1) psychological factors, (2) environmental and social factors, (3) characteristics of the therapeutic regimen, and (4) properties of the physician-patient interaction. Based on this information, a strategy for the improved diagnosis and management of noncompliance is feasible.

(JAMA 228:1563-1567, 1974)