Adhering to Medical Advice: A Review

have brought us drugs with demonstrated efficacy in the management of many diseases. Yet even in areas in which we have relative certainty that we can prevent or manage various disorders, people often do not follow the recommended course of action. It is a modest percentage of patients who heed medical advice. Even when it comes to just keeping patients in treatment, that is, to their appearing for scheduled appointments, the failure rate averages 20%50% (Dunbar & Stunkard, 1979). In the area of treatment, 20% -80% of patients make errors in taking their medications; and 25% -60% stop taking their medications well before it is therapeutically desirable to do so (Dunbar & Stunkard, 1979). Life-style modifications fare no better: 20%-80% of patients drop out of weightmanagement programs, and as many as 90% -9 5% of those in such programs fail to achieve a desirable weight (Dunbar & Stunkard, 1979). Efforts to stop smoking also do poorly; indeed, the success rate seems to be somewhat like that for the treatment of alcoholism or heroin addiction. Of people who have embarked on a smoking reduction program, up to 75% have resumed smoking six months after they quit (Best & Block, 1979). Data on