Clinical pharmacist challenges common assumptions about medication non-adherence

A clinical pharmacist argues that standard explanations for why patients stop taking long-term medications are incomplete. While common theories suggest patients forget doses, become frustrated with side effects, or do not understand their conditions, the author states that clinical experience revealed these factors only tell part of the story.

The author observed this pattern across multiple medical specialties. In psychiatry, patients with schizophrenia experienced psychotic episodes after stopping antipsychotics, and those who abruptly discontinued antidepressants suffered withdrawal symptoms. Similar outcomes appeared in a kidney transplant center, where patients who stopped taking one or more immunosuppressants developed acute rejection of their new kidneys.

Colleagues in cardiology and primary care reported comparable experiences. The author concludes that the reasons for non-adherence are more complex than previously thought.