Noncompliance With Medication Therapy: An Analysis of Nationally Representative Data

Poor adherence to treatment is a critical factor underlying treatment failure in dermatology. Nonadherence on a national scale is not well characterized. The purpose of this study was to examine nationally representative data on the factors associated with poor adherence and evaluate the rate of poor adherence reported by dermatology patients in comparison to that reported in other physician specialties. Data from the National Ambulatory Medical Care Survey (NAMCS) were analyzed from 1999 to 2007 for which “noncompliance with medication therapy” was noted as a reason for visit. Our focus included associated patient demographics, medications, and diagnoses, as well as the rates of reported noncompliance among dermatologist and other physician encounters. Reported noncompliance rates were low (0.04% of overall visits to the doctor). There was a small but significant increase (P=.02) of noncompliance-related visits over time. The rate of noncompliance reported at dermatology visits was lowest among all specialties. A major limitation of this study is that it captures patient-reported noncompliance and not actual noncompliance. Poor adherence to medication regimens is a problem common to all medical fields. Although noncompliance is a cause of treatment failure in dermatology, patients are unlikely to report noncompliance to dermatologists.