Part II: the role of trust in patient noncompliance: a quantitative case study of users of statins for the chronic treatment of high cholesterol in New York City

Sweta Chakraborty

Journal of Risk Research, 2013, vol. 16, issue 1, 113-129

Abstract: It is widely known that increased perceived risk associated with a drug, even if in a completely different class of medicines, may influence patient compliance to their treatment regimes. Media reports of alleged scandals and controversies associated with certain prescription drugs, such as Vioxx, are easily accessible in public recollections and may influence attitudes towards other drugs. Reports of increased noncompliance following such media reports contribute to the existing 50--70% of the US adult population of chronic prescription users who do not take medications in accordance with physicians' instructions. This can have impacts ranging from faster onset of disease for the noncompliant individual to wider impacts for society as a whole, such as increased federal spending on social health funds. The rates of noncompliance described, and their alleged relationship with increased public suspicions, suggest a role for trust in shaping compliance behavior in patients. This study applied the mental models approach for the purpose of understanding lay perceptions in relation to existing scientific information on the risk of noncompliance. In accordance with the approach, 30 participants were interviewed, and 200 questionnaires were administered in New York City to eligible users of statins for the chronic treatment of high cholesterol. This original research reports the primary findings from the 200 confirmatory questionnaires in relation to the qualitative interview findings from the previous article. The themes of distrust in various actors in the health care system identified during the interviews were supported statistically through the questionnaires, and a statistically significant correlation between distrust and noncompliance was established. The results of this research should be taken into consideration for any future efforts at addressing risks associated with patient noncompliance.

Date: 2013
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DOI: 10.1080/13669877.2012.727098

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