Patients' use of medication, and their adherence to treatment, is often terrible. Even when patients are just given one medicine to use once a day, use is intermittent and gradually decreases over time. Sometimes, the rapidity of decreased use is more precipitous than gradual.
Based on my training and habits, I often find myself prescribing complex acne treatment regimens, regimens that include multiple treatments, both oral and systemic, to teenage patients with acne. It's not at all unusual for me to prescribe an oral antibiotic, a topical antibiotic, a benzoyl peroxide preparation and, of course, a topical retinoid. The use of combination treatments, at the very least a topical retinoid along with some type of anti-infective treatment, is standard care according to established acne treatment guidelines.
What am I doing!? Do I really expect teenagers to use such complex treatment regimens even when the available evidence suggests that they use even single agents quite poorly?
How can we get patients to better use multiple drug treatments? Well, one way is to combine the treatments into single products. But in the case of acne, even if we do prescribe one combination product, we often want the patient to use some other treatment along with it.
Perhaps we can get patients to use multiple acne treatments by making them think they are actually doing a single treatment program. I learned in medical school that one way to assess patients' memories is to test their ability to remember a series of numbers. Healthy minds can remember about seven digits. But people can remember many more numbers if they learn them in chunks or in groups.
Perhaps we can get patients to use a complex treatment program better by emphasizing that it is a ‘single treatment program’, not multiple individual treatments that they have to come up with. While I'm not aware that this psychological trick has been tested, I expect that it would be an effective means to squeeze better compliance out of our patients.