Irrational Choices, Unfathomable Outcomes: Patient Ethnographies in Pharmaceutical Research

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ARI SHAPIRO

With the proliferation of oral therapies (in place of injectables) for many chronic conditions, the locus of medical treatment is shifting from the surveilled context of the clinic to the private space of the home. In the home, compliance and persistency – the extent to which patients take medications over time – have become pressing concerns. Non-compliance adversely affects health outcomes, and costs manufacturers millions. The medical community has difficulty understanding non-compliance, often relegating it to individual irrationality or dysfunction in the doctor-patient relationship. Ethnography opens up the issue by entering the private space of pill-taking to understand the beliefs, relationships, and activities that contribute to patient (non-)compliance.

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