Comments on: The adherer effect

By: Do Drugs Save Money? Check The Assumptions « Rx Outcomes Adviser

Do Drugs Save Money? Check The Assumptions « Rx Outcomes Adviser — Tue, 11 Jan 2011 17:36:29 +0000

[...] examination of medication compliance against total medical spend is highly problematic due to the Healthy Adherer Effect, which is the tendency of people who are adherent to their medications to also engage in other [...]

By: Colorectal Cancer : : Polyp Prevention Trial and homocysteine - Cancer Health Center

Thu, 15 Jul 2010 14:31:14 +0000

[...] I would also point out that “super compliers” are super compliers. These are the sort of people who meticulously take their placebo tablets in clinical trials and consistently do better than those who are lackadaisical with consuming their placebo tablets. Mike Eades has blogged about it nicely here. [...]

By: Dickson

Dickson — Fri, 09 Jul 2010 09:04:56 +0000

paul is definitely the meanest oracle .

By: Ted Hutchinson

Ted Hutchinson — Fri, 07 Aug 2009 13:41:55 +0000

Donation of Blood Is Associated with Reduced Risk of Myocardial Infarction: The Kuopio Ischaemic Heart Disease Risk Factor Study Now could this be the Adherer effect? The type of people who regularly give blood being those who are concerned about health and have particular attitudes that are helpful in promoting good health. Or Lowering of body iron stores by blood letting and oxidation resistance of serum lipoproteins These observations indicate that the reduction of body iron stores by venesection can increase the oxidation resistance of serum VLDL/LDL in regularly smoking men. The finding that blood donor are replicated here A historical cohort study of the effect of lowering body iron through blood donation on incident cardiac events. Frequent and long-term whole blood donation is associated with a lower risk of cardiovascular events. It could be a little adherer effect, but blood donation brings about many healthful changes, so I don't think the adherer effect is all that's at work.

By: Lisa Daniels

Lisa Daniels — Fri, 31 Jul 2009 18:34:13 +0000

Very interesting post. I wonder if forced adherence would increase life span/health? My mother uses a pillbox from MedMinder (http://www.medminder.com) to increase her adherence – she takes Statins and a host of other medication. I watch like a hawk and make sure that she takes all her medication. It would be interesting to put have my dad use the box as well for his vitamins and see if making him an adherer helps reduce his perpetual minor health complaints and general sense of being.

Do a study of it and let me know.

By: Pat Duffy

Pat Duffy — Thu, 30 Jul 2009 17:00:16 +0000

A few years ago the Canadian Council on Animal Care pointed out that most medical research is not “good science” from an analytical statistics viewpoint. Any decent statistics program could do a two way Analysis of Variance with the 4 groups – this would easily test whether results are due to the drug or to adherence. It could also analyze the non-adherent people into true non-adherents and those who dropped because of side effects. But most medical researchers are statistically illiterate.

True. But you would never know it from the way they blather on about it.

By: Jim Purdy

Jim Purdy — Sun, 26 Jul 2009 23:42:55 +0000

In many studies, there are high percentages of people who don’t adhere” — folks whom doctors dismiss as “non-compliant.”

I am a very noncompliant patient, because I tend to have severe adverse events from almost all medications.

I would argue that persons who make a deliberate decision to be non-compliant, based on side-effects, may be better attuned to their bodies, and they should be studied more seriously, and not scorned.

Because I refuse to take most meds, I end up doing a lot of Seth Roberts-type self-experimentation, and I learn things that are not discovered in typical studies funded by BigPharma.

I have learned that, for me at least, a careful diet has much more beneficial results than any drugs.

Of course, that lesson will never be discussed in any BigPharma literature.

By: shutchings

shutchings — Sun, 26 Jul 2009 20:23:44 +0000

I feel like a lazy schlub. Now that I’ve got a good mayo recipe, I can certainly figure out my own ranch dressing. Again, thanks much.

By: Grant

Grant — Sun, 26 Jul 2009 09:00:25 +0000

I blame widespread ignorance/evasion of the adhearer effect, like so many other things, on philosophy. Specifically, modern philosophy. So much of today’s conventional wisdom about so many aspects of life is created around the idea that man is not primarily a conceptual being. The “rational animal” – to quote Aristotle.

Everyone is always looking for some explanation that allows them to not have to use their mind’s fully. They are told repeatedly that philosophizing is one thing, living is another. So when it comes to living, is it really any wonder that most people will swallow just about anything with an appearance of credibility? They never bother to examine to see if it contradicts basic philosophical axioms.

It seems the only way anyone can get any rational philosophical ideas into the culture nowadays is to disguise them in scientific jargon. I’m glad that the adhearer effect is out there – it’s true – but if people were taught how to think properly before they were taught how to practice a particular profession, erroneous conclusions would not be so common.

To me, who, fortunately, came to appreciate the central role that ideas play in all parts of the human experience at a relatively young age, the suspicion that someone who is undisciplined about their health in the first place would be undisciplined about improving it seems obvious. Omitting factors beyond their control, it was a lack of respect for reality that got them to where they are so, most likely, it’s going to be a lack of respect for it that will keep them there.

By: kris

kris — Sun, 26 Jul 2009 05:33:03 +0000

I wonder what role conformity plays in the adherer effect. Conformists are more likely to follow the rules, do what is expected of them etc., making them good adherers. What impact could this have on mortality rates in cultures that encourage conformity � Is it possible Japan’s longer life expectancy is due to conformity, adherence… not diet.