Distrust in Medication is a Significant Cause of Medication Non-Adherence, Studies Suggest

Recent Valisure study of 2,000 people supports finding from the American Medical Association

Medication non-adherence is a commonly used term to describe a patient who does not take a prescribed medication or follow a prescribed course of treatment as directed by their healthcare provider. Multiple factors contribute to non-adherence, and a patient’s ability and willingness to follow a prescribed regimen directly influences the effectiveness of that therapy. Non-adherence takes many forms including delaying or not filling a prescription, skipping doses, splitting pills, or stopping a medication early.

A 2015 study by the American Medical Association outlined eight factors that contribute to medication non-adherence: fear, cost, misunderstanding, too many medications, lack of symptoms, worry, depression and mistrust.

A December 2018 survey of 2,046 participants conducted by Valisure through Google Consumer Surveys yielded similar results to the 2015 AMA study with a big influencing factor for medication non-adherence still being mistrust. Valisure’s survey showed that of Americans who are on prescription meds and have intentionally chosen not to take their medications,15% responded that their non-adherence was related to the fact that they didn’t trust their medications with 5% specifically citing that they don’t trust generic medications. These results illustrate that, even three years later, concerns about medications and trust in the system are very real issues.

Mistrust and fear as contributing factors to non-adherence could be influenced by the increasing prevalence of major news about medication quality issues. Medication recalls (many of which in 2018 were due to cancer-causing contaminants from China), questions regarding the safety of generics, and overseas manufacturing violations are in the news on a daily basis. And many of these headlines are certainly real causes for concern. 80% of the ingredients in our medications are manufactured in India or China; over 1,000 overseas manufacturing facilities have never been inspected by the FDA; and there are an average of roughly three drug recalls every day in the US.


Overseas manufacturing for the majority of generic medications and the incredibly complex global supply chain are valid concerns affecting quality of American medications. Increased news and general awareness of this could be leading to distrust and non-adherence.


Medication non-adherence to prescribed regimens can result in serious health consequences, ranging from decreased quality of life to reoccurring symptoms and even death. Therefore, addressing medication distrust is the responsibility of both patients and healthcare providers.

While patients may often be focused on short-term benefits and may not fully realize the future implications of medication non-adherence on their overall health, it’s important for them to know it’s ok to ask questions and be fully involved in their own care. Discussing patient concerns and increasing awareness of newly available chemically-validated medications, could help to restore trust. Hopefully through increased engagement, the pharmaceutical industry will also be called upon to make changes that will help restore consumer confidence.

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