The researchers found out for what reasons Russian patients most often do not comply with the prescriptions of doctors

The most common reason why Russians do not listen to doctors is the high cost of treatment.

The most common reason why Russians do not listen to doctors is the high cost of treatment.

A photo: Shutterstock

Hand on heart, each of us, to one degree or another, ignores the prescriptions of doctors. And few people do it out of maliciousness or outright disregard for their health. Otherwise, they would not go to the doctors. In fact, patients have quite convincing – in their opinion – reasons not to comply with medical prescriptions, doctors themselves admit.

Seeing the poor results of treatment or their absence, cardiologists, endocrinologists, ophthalmologists and other specialists ask their “wards”: did they strictly follow all the recommendations? Some honestly answer no. Other experienced doctors are caught cheating, including, for example, according to the results of tests. In the medical community, the topic of adherence to treatment, or, in professional terms, patient compliance, is being discussed very actively. About what doctors encounter most often, they told sociologists. The results of the Ipsos Medi-Q study were presented at a closed meeting of the Russian Pharmaceutical Marketing Association (RAPM), reports “Bear”.

Here are the top reasons why patients most often do not comply with doctors’ prescriptions:

– too high cost of treatment;

– misunderstanding (underestimation) of the consequences for health in case of non-compliance with the doctor’s recommendations;

– possible side effects of the prescribed drugs (that is, corny, the fear that the pills will hit the body even harder than the disease itself. – Ed);

– inconvenience associated with taking medications / following recommendations (special daily regimen, nutrition, etc.);

– lack of therapeutic effect of previously prescribed drugs – this gives rise to distrust in new prescriptions;

– doubts about the impartiality of the doctor – the patient thinks that the pharmaceutical company “paid” the doctor for the prescription of specific pills;

– doubts about the competence of the doctor.

Seeing the poor results of treatment or their absence, doctors ask their “wards”: did they exactly follow all the recommendations?

Seeing the poor results of treatment or their absence, doctors ask their “wards”: did they exactly follow all the recommendations?

A photo: Shutterstock

The researchers also decided to find out whether patient adherence to treatment depends on the doctor’s profile. It turned out that yes.

* Patients obey better (“compliance is above the average level”) of such medical specialists: gastroenterologists, gynecologists, ophthalmologists;

* Worse follow the recommendations (“compliance below average”) patients of such doctors as: general practitioners, endocrinologists, neurologists, surgeons, cardiologists and rheumatologists.

70% of the healthcare professionals who took part in the study said they were taking steps to encourage patients to comply with the prescriptions. Most often, two methods are used for this. First, they explain the tactics of treating the disease: why such treatment is prescribed and how it will help. Secondly, they warn of the dangerous consequences of non-compliance with the recommendations.


Treatment adherence is higher for acute conditions and lower for chronic conditions.

We asked for comments on the results of the study. director of the Institute of Health Economics Larisa Popovich.

– According to sociologists, about 60% of our population answered the question “How much do you trust the recommendations of doctors?” respond that they prefer self-treatment. This is a very high percentage. Patients usually refer to the fact that they do not trust the advice of health workers because of their low qualifications.

However, practice shows: when a person becomes really ill, he discards all doubts and runs to the doctor. And the results of sociological research depend on the questions posed, and on the subjective perception, and on the nature of the respondents. So everything is not so clear.

In general, there is such a pattern. If the disease or condition is acute (poisoning, an attack of a chronic illness, etc.), then, as a rule, the patient strictly follows the doctor’s instructions. Apparently, gastroenterologists, gynecologists, and ophthalmologists, who reported in the study about the higher compliance of their patients, had more such patients. If the disease is chronic and a person needs to take courses of drugs for a long time or for life, follow recommendations on the regimen, etc., then such prescriptions are carried out less willingly. People get bored, they get tired. And the situation is still not acute. Although, in reality, the threat of extremely dangerous complications in chronic diseases can be very high.

“Medicine holidays” lead to strokes and heart attacks

From year to year, neurologists and cardiologists talk about this problem at medical conferences. If a patient has a stroke, heart attack, or transient ischemic attack (mini-stroke), he is prescribed certain drugs for life. Breaks are not allowed under any circumstances. Otherwise, the threat of repeated vascular catastrophe jumps many times over.

However, many people who survived the attack and more or less healed, after a while, “get tired” of constantly taking pills. And arrange a “drug vacation”.

– A hypertensive patient goes on vacation and decides: let the body rest not only from work, but also from drugs. It’s nothing if I take a break for a couple of weeks or a month, the doctors describe. – And then we accept such “drug vacationers” with strokes and heart attacks.

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