It is estimated that one in four people do not take their prescription medications as directed. Taking prescribed medications is important for treatment success, and healthcare providers struggle to get patients to take their medications properly. Studies have shown that faithful medication adherence is associated with better health outcomes and a lower risk of death. But curiously, these benefits are even seen with adherence to placebo medications (dummy pills) used in clinical trials.

A new study in the July 1, 2006 issue of the British Medical Journal looked at the results of a collection of studies and found that, compared with poor medication adherence, good adherence was associated with a lower risk of death, even with placebo medications.

About the Study

For their analysis, researchers identified 21 studies that included 46,847 participants. All of the studies categorized the participants as either good or poor adherers to the study medication, and reported the number of deaths in each group. The researchers used this data to evaluate the association between medication adherence and risk of death.

Overall, 2,779 participants died during the studies. Compared with poor adherence, good medication adherence was associated with a 44% reduced risk of death. The same was true for good adherence to placebo medications. In two of the studies, the medication was found to increase the risk of death. Good medication adherence in these studies was associated with almost a three-fold increased risk of death.

These findings are limited because the studies used a variety of definitions for good medication adherence, so the researchers were unable to define the optimal level of adherence.

How Does This Affect You?

This study supports previous research that has linked medication adherence with positive health outcomes. But it may not be the medications themselves that directly improve health, since placebo adherence was just as beneficial as adherence to real medications. One explanation for this interesting finding is that the medications themselves are not providing the benefit, but taking medications as directed is a predictor of having healthy behaviors. In other words, people who tend to adhere to their prescriptions also adhere to other treatments and recommendations that improve their health.

But could there be more to the story? As an accompanying editorialist points out, it is plausible that people who take their medications and believe in their treatments may be more likely to expect recovery. And, it is this expectation of benefit, or faith in the prescriber, which leads to better health outcomes.

Keep in mind that since certain medications are necessary for good health—even survival—it is important to discuss any doubts or concerns you may have about your medications with your doctor.