Pitfalls to Avoid in Treatment

Abstract

Over the past 15 years a valuable series of studies has focused on the extent of and the reasons for nonadherence to treatment regimens for chronic conditions. These investigations have been extremely revealing. Even for moderate to severe chronic diseases (including allergic complaints), more than half of all patients fail to stick with the course of treatment prescribed by their physicians. Complete or partial nonadherence to what the doctor orders is the rule rather than the exception in patient behavior.

Ralph, 8, has moderate asthma that usually shows up with a respiratory infection. His condition seriously concerns his mother, who keeps going from one treatment approach to another in the hope of finding a “cure” for Ralph’s wheezing. Over the past three years, he has seen a chiropractor, an acupuncturist, and a psychic “healer” as well as the family doctor; he has taken a whole string of home remedies—the one consisting of a steaming hot mug of “natural” honey, lemon juice, and bourbon whiskey made him very sleepy, impaired his breathing, and put him in the emergency room; he has swallowed massive doses of vitamins, minerals, and trace elements; he has briefly followed a succession of “free” diets; and he has eaten more “health” foods than one would believe possible. His symptoms meanwhile just keep going on.