Comment & Response |

Nonadherence to Medications

Toby Schonfeld, PhD1; D. Micah Hester, PhD2
[+] Author Affiliations
1Center for Ethics, Emory University, Atlanta, Georgia
2University of Arkansas for Medical Sciences, Little Rock
JAMA. 2013;310(14):1504-1505. doi:10.1001/jama.2013.277296.
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To the Editor We take issue with both the characterization of medication nonadherence by Dr Marcum and colleagues1 as a “diagnosable and treatable medical condition” and at the physician-centered nature of these claims.

First, although there is value in a systematic approach to medication nonadherence, we disagree with medicalizing the issue. Classifying a condition as a disease or illness is not value neutral; medicalizing the problem entails labeling the issue in ways that can have negative effects (such as stigma) on those who fall into this category.2 Adding another disease to a list of problems experienced by many nonadherent patients may create additional vulnerability.


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October 9, 2013
Zachary A. Marcum, PharmD, MS; Mary Ann Sevick, ScD, RN; Steven M. Handler, MD, PhD
1Division of Geriatric Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
2Department of General Internal Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
3Department of Biomedical Informatics, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
JAMA. 2013;310(14):1506-1507. doi:10.1001/jama.2013.277311.
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