Take your medicine as prescribed to the end of the course, and don't stop just because you feel better
- High value
- Evidence A
- Buys life
- Disputed
- Free
- Takes minutes
- Long-term effort
In plain words
People who take their medicine fully as the doctor said are about half as likely to die over the same period as people who take it on and off. Take that number with a grain of salt. People who take even a fake pill faithfully also die less often, which shows that part of the benefit comes from "people who can stick with their medicine already look after their health more." But the harm of stopping is certain, especially with blood-pressure drugs, blood thinners and anti-rejection drugs.
- Cost
-
Free, and it saves money you would later spend treating complications. Taking medicine takes only a few minutes a day. The hard part is taking it every single day.
- What you get
-
A combined analysis (meta-analysis) of 21 studies and 46,847 people: compared with people who took their medicine on and off, people who took it fully as prescribed had 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 range). Looking only at treatments that really work, about 45% lower (0.55, 0.49–0.62).
- Notes
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Disputed. This is also the number in this book that most needs to be taken with a grain of salt. In the same pooled analysis, people who faithfully took even a placebo (a fake pill) also had lower mortality (0.56, 0.43–0.74). This suggests that a good part of the benefit comes from "people who can stick with their medicine already look after their health more." The authors call this mixed-in factor the healthy adherer effect. But the harm of stopping the medicine itself is clear, especially with blood-pressure drugs, blood thinners and anti-rejection drugs.
- Evidence grade
- A : Specific numbers from meta-analyses, large cohorts or randomized trials; for law and policy, the statute or official text.
- Sources
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- 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. https://doi.org/10.1136/bmj.38875.675486.55
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Translated from the Chinese original. Original book, section 16, tip 1. This section is about health and medicines. It is general information, not a substitute for a doctor’s diagnosis or prescription. Content may be out of date and rules differ by place. When you actually deal with an agency, a doctor or a court, follow what local officials, doctors and lawyers tell you. Disclaimer