Managing medication and compliance: physician--pharmacist--patient interactions

Behavior characteristics of both health care practitioners and patients are discussed in terms of their effects on the delivery of care and the rational use of drugs. Three modes of behavior are described: the instrumental, the customary, and the command modes. Although most physicians follow the customary mode, an instrumental approach is recommended both for patient interactions and for drug selection. Patient education is often insufficient, and physicians tend unjustly to blame the failure of a treatment regimen on the patient's lack of compliance. An "index of risk" is presented to help spot potential drug defaulters, as are clues in the behavioral diagnosis.