Patient decision making. The missing ingredient in compliance research

Int J Technol Assess Health Care. 1995 Summer;11(3):443-55. doi: 10.1017/s0266462300008667.


Medical noncompliance has been identified as a major public health problem that imposes a considerable financial burden upon modern health care systems. There is a large research record focusing on the understanding, measurement, and resolution of noncompliance, but it is consistently found that between one third and one half of patients fail to comply with medical advice and prescriptions. Critically absent from this research record has been the patient's role in medical decision making. For patients, particularly those with chronic illnesses, compliance is not an issue: they make their own reasoned decisions about treatments based on their own beliefs, personal circumstances, and the information available to them. The traditional concept of compliance is thus outmoded in modern health care systems, where chronic illness and questioning patients predominate.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Attitude to Health
  • Drug Therapy / psychology*
  • Internationality
  • Motivation
  • Paternalism
  • Patient Compliance
  • Patient Participation
  • Personal Autonomy
  • Physician-Patient Relations
  • Terminology as Topic
  • Treatment Refusal* / psychology