Take the medicine as prescribed for the full course; do not stop because you feel better
UpdatedGrade ABig benefitLifespanFreeLittle timeHigh willpower
People who take the medicine for the full course, as the doctor said, have about half the chance of dying over the same period as people who take it on and off. Discount this figure. People who take even a dummy medicine for the full course also die less often, which shows that part of the benefit comes from "people who can keep taking medicine were already paying more attention to their health."
- Cost
- No cost; it saves the money that would later go to treating complications. Taking the medicine each day takes only a few minutes. The hard part is not missing a day.
- Benefit
- Pooled from 21 studies and 46847 people (meta-analysis): compared with people who take medicine on and off, people who take it as prescribed have about a 44% lower chance of dying over the same period. The original value is an odds ratio of 0.56, 95% CI 0.50–0.63 (confidence interval). Looking only at treatments that truly work, about 45% lower (0.55, 0.49–0.62)
- Notes
- Disputed. This is the figure in this book that most needs discounting. In the same pooled analysis, people who took even placebo (a dummy medicine) for the full course also had lower mortality (0.56, 0.43–0.74). That shows a large part of the benefit comes from "people who can keep taking medicine were already paying more attention to their health." The author calls this mixed-in factor the healthy adherer effect
Sources · 1
- Simpson SH, Eurich DT, Majumdar SR, et al. (2006). A meta-analysis of the association between adherence to drug therapy and mortality. BMJ, 333(7557), 15. doi.org/10.1136/bmj.38875.675486.55