Skip to main content

Medical compliance and social issues

There is a contest here to find interesting things patients do to increase their adherence to their drug regimens. That is of course the 6 million dollar question that the whole medical profession is asking, and there are even international conferences around it.

As an anthropologist, I find the more interesting question is why people are not compliant. My friend Ari Shapiro did an interesting study on this, noting that "Ethnography opens up the issue by entering the private space of pill-taking to understand the beliefs, relationships, and activities that contribute to patient (non-)compliance." The abstract for his paper is available at the EPIC website, but you have to be a member of Anthrosource to get the whole thing.

His study, as well as many articles in the popular media, point to the fact that compliance is about much more than remembering to take pills at the right time. Medications can make people feel awful, or look awful, or be unable to participate in important family events. Teenagers with cancer don't really believe they might die. The list goes on.

Interestingly, in my (admittedly very cursory) research, it looked like HIV/AIDS patients are a constituency which overall is very concerned with being compliant, but it is difficult because of all the cocktails and combinations of meds that must be taken at different times. I found several instances of people looking for community solutions (say text messaging each other) to help remember. I am not sure why this is different that other diseases (if in fact it is, or just a sampling error in my own research) but it is interesting nonetheless.

Comments

Anonymous said…
There is a large biomedical literature on this topic. although I haven't seen many applied anthropologists examing this issue. Most work is not systematic and there is little descriptive or formative work. Most interventions are not very empowering, which means that persons taking medications (especially for chronic diseases) have to examine their realities (including aspects of daily life (time management), quality of life, finances, cultural values and beliefs, etc.; and then come up with their own solutions collectively (as did the people with HIV who text message each other). People also have to believe that the treatment is effective (that it works) compared to the effects of the medications. For example, it is well known that the discomfort with hypertension medications is high because there are no or few symptoms when one does not take them. In addition, survival may not be that important to the elderly given their declining quality of life. People do need information support (reminder) systems. As applied anthropologists, we have to be careful ethically in our studies because we should not be taking the side of commercial biomedical establishment, and dedicate ourselves to promoting questionable medical practives and products.
Jose Arrom j.arrom@comcast.net
9:50 AM
Post a Comment

Popular posts from this blog

Anthropology and advertising?

I read an interesting article on trend forecasting today. I've always found this fascinating (and wonder how much anybody checks later to see if the forecasters were right). The only thing that bothered me about this one, and this is not new, is the claim that what they do is like cultural anthropology. This is not a diss on advertising, marketing, trend forecasting, or any of the other fields that claim to be like anthropology--these folks to interesting work. I am just annoyed at the claim itself. Granted, we anthropologists are not always good at advertising ourselves...in that we offer a holistic approach, and theoretical insight based on our training. So anybody who observes people is now an anthropologist. Or is it just that Americans are so used to sound bites that they don't understand the nuanced differences in anything? Sigh.
2 comments
Read more

To Label or Not to Label?

Blogger now not only allows me to tag my posts (that's label in google talk for some reason), but I can display for all my readers the labels and how often I have used them. For now I have added that widget (see right side of the screen). At first, I thought I would go back to all my old posts and tag them (maybe I still will). Then it seemed daunting. Then I worried about being somewhat consistent in my tagging, so that a reader could clearly see that I write a lot about anthropology, or social media. But then I looked at my posts and realized I actually write about a lot of different things. So if I start labeling, do I end up with just a long list of tags? Or do I then feel a need to constrain what I write about to a defined set of categories? I realize blogs with a theme are powerful...and I think I have some themes running through here...interspersed with random thoughts or items that catch my interest. What to do? Does it matter? Is there meaning in tags (beyond the me
Post a Comment
Read more

Yammer and distractions

We had a very interesting teleconference with some folks from Yammer on Friday. It was a great opportunity to learn about best practices and for our security minded folks to ask questions in that arena. There were probably 10 or 12 people on the call, mostly non-colocated, and several were live yammering the call. While I didn't add posts describing the content of the call, I did join into the discussions. It was an interesting experience for me. It was nice to have the side conversations, but I have to admit it was also distracting. Is it any less rude or distracted than emailing in a face to face meeting? I suppose since it was based in teh content of the meeting it may bedifferent...I know others found value in reading the yams later. I should perhaps fess up to trying to do some other work as well, but I know it distracted me and I am trying (not always successfully) to cut down on the mutlitasking to be more focused. My most important reminder to try not to be distracted is Ju
1 comment
Read more