Comments on: The adherer effect

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.

By: shutchings

shutchings — Sun, 26 Jul 2009 01:31:24 +0000

I finally got around to making your wife’s mayonnaise. Never in my wildest dreams did I think I would be tempted to eat mayonnaise by the spoonful, but today it happened. Now if you could just get her to post a ranch dressing recipe. In the meantime, I’ll try the Caesar. Thank you, thank you.

I have trouble getting her to post anything right now. She’s swamped with work on the multiple projects we’ve got going right now. The Caesar is great – you won’t be disappointed. I told her of your comment, and she said she would work on a ranch dressing recipe. Don’t hold your breath, though, for anything, any time soon.

By: Paul Anderson

Paul Anderson — Sat, 25 Jul 2009 11:48:42 +0000

Reference the date of the release on the 2 bars of chocolate a day study – it wasn’t by any chance April 1st. Quite amazing really. Maybe they could run another one where participants eat 12 spoonfuls or sugar every day, as this is a low fat food. Or they could advocate high carb low fat diets for diabetics (and everyone else) …… oh, hang on, they do……… Based on what evidence you might well ask.

By: Josephine K

Josephine K — Sat, 25 Jul 2009 10:52:04 +0000

I think I might be familiar with the “adherer effect” as it relates to my 88 yo mom who got a stroke in 2006. As you know, once one has committed the sin of having a stroke or heart attack, the doctors bombard him/her with a load of drugs that come with those nasty drug side effects. My mom had to “adhere” to taking those drugs for the rest of her life or else the doctor threatened to not be her doctor anymore and doctors in her town weren’t taking new patients. So my mom “adhered” to the doctors instructions and faithfully took her drugs which included 20 mgs of a statin, a thyroid drug, a beta blocker and a drug for CHF. The CHF developed after taking the statin. Her “adherence” to her drugs made it impossible for her to operate any motor vehicles or get into any kind of accidents because all she could do each day was sit in her living room and waste away. Within 6 weeks after being on the statin she began repeating her questions. From a very ambulatory person, her muscles wasted away and she literally became a cripple. Yes, her “adherence” turned her into a model puppet patient alright just like the medical system wanted. She had abnormally low cholesterol levels, she suffered from constipation, she had a constant hacking cough, her memory loss worsened, she became a cripple and she wasn’t her normal self anymore. “Adherence” keeps the patient just sick enough so that he or she “adheres” to the desires of a controlling medical system.

A sad story and one that is all-too common. Forced adherence isn’t really the adherer effect, though.