Taking Medicine Regularly (even Placebo) Is Good For You

July 4, 2006

People who take their medicine regularly, even dummy (placebo)

medicine, have a lower risk of death than those with poor adherence,

finds a study in this week's BMJ.

This intriguing finding supports the concept of the " healthy adherer "

effect, whereby adherence to drug treatment may be a marker for

overall healthy behaviour, say the authors.

They analysed 21 studies involving over 46,000 participants. For

those with good adherence to drug therapy or placebo, the risk of

mortality was about half that of participants with poor adherence.

Possible reasons for this effect are that participants with good

adherence to study drugs (even placebo) may also have good adherence

to other healthy behaviours, which could independently affect the

risk of mortality, explain the authors. Conversely, participants with

poor adherence may have consciously chosen to use a lower dosage or

have other conditions, such as depression, that affect adherence.

" Our findings support the tenet that good adherence to drug therapy

is associated with positive health outcomes, " they write.

" Moreover, the observed association between good adherence to placebo

and lower mortality also supports the existence of the healthy

adherer effect, whereby adherence to drug therapy may be a surrogate

marker for overall healthy behaviour. "

In an accompanying commentary, US researcher Betty Chewning suggests

that it is quite possible that people who adhere to healthy

lifestyles also tend to take care of themselves by greater adherence

to prescribed treatments.

She points to research showing that healing may lie not in the

treatment but rather in patients' emotional and cognitive processes

of " feeling cared for " and " caring for oneself. " And she suggests

that practice based on these hypotheses " could yield extra value in

treatment regimens that patients agree to, believe in, and will

sustain over time. "

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BMJ volume 333 pp 15-18

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