Physicians' and patients' judgments of compliance with a hypertensive regimen

This study examines an early decision point in the process of compliance. Thirty primary care physicians and thirty outpatients responded to a series of written scenarios. These scenarios systematically incorporated four factors thought to affect adherence to a hypertensive regimen--convenience, cost, severity, and support. Data were analyzed using multiple regression and multivariate analysis of variance. A mean R2 was obtained of 0.70 for physicians and 0.58 for patients. In making these judgments, physicians and patients placed similar emphasis on cost, convenience, and severity, but physicians placed greater emphasis on support. There was a significant difference between the judgments of physicians and patients (p less than 0.0001). Patients tended to be more optimistic than physicians regarding adherence and put more importance on severity of illness than on support. These findings are useful to the clinician concerned with compliance and demonstrate the potential of this paradigm for research in clinical reasoning.