Part I: the role of trust in patient noncompliance: a qualitative case study of users of statins for the chronic treatment of high-cholesterol in New York City

Current reports state that 50--70% of American patients who have been prescribed chronic drug therapies do not take their medications in accordance with their physician's instructions. This not only leads to poorer end-prognoses, but can add up to 100 billion dollars in terms of public health costs stemming from more rapid onsets of disease, higher rates of hospitalizations, and lost productivity. The unresolved magnitude of such adverse outcomes merits a deeper inspection into the risk of noncompliance, particularly in relation to the current climate of social distrust. This study applied the mental models approach for the purpose of understanding lay perceptions in relation to existing scientific information on the risk of noncompliance. In accordance with the approach, 30 participants were interviewed and 200 questionnaires were administered in New York City to eligible users of statins for the chronic treatment of high cholesterol. This original research reports the primary findings from the 30 qualitative in-depth interviews. Several themes of distrust in various actors in the healthcare system were identified during the interviews and a suggested correlation between distrust and noncompliance emerged. The results of these findings should be taken into consideration for any future efforts at addressing risks associated with patient noncompliance.