Earlier this month, scientists at Georgia Tech announced their invention of a necklace that records the date and time at which a person swallows his prescription medicine. The device (which looks more like a dog collar than jewelry) responds to a tiny magnet in the pill as it travels down the esophagus. Other recently developed similar technologies include a drug-filled prosthetic tooth that slowly drips medicine into the mouth and a pill bottle that sends a wireless message to your pharmacist every time it's opened.
Are we so bad at taking medicine that we need false teeth to do it for us and pill bottles that tattle on us when we don't? It would seem so. About 50 percent of patients fail to correctly follow prescriptions: We forget to take pills, we alter doses, we take breaks. Nonadherence—the medical term for neglecting to abide by a doctor's orders—is rampant, resulting in up to one-quarter of all hospital and nursing home admissions. It's also expensive. The problem persists despite monumental efforts to prevent it. Why? For one thing, it's impossible to predict which patients are likely to deviate from their orders. And while the problem seems like it should have a simple solution, it doesn't. Nonadherence, it turns out, is one more reason to heed the call for better American health care.
Blowing off a doctor's instructions might seem like the act of a basically healthy person. Who hasn't neglected to take that last antibiotic or exercised less than the doctor said to? But treatment drop-off rates are high among the seriously ill, too. About half the people who undergo kidney transplants do not adequately adhere to the regimen necessary to thwart rejection of their new organ. A 1970s study found that 43 percent of glaucoma patients refused to take the doctor-ordered measures necessary to prevent blindness, even when that refusal had already led to blindness in one eye.
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