A Pill a Day? No Way, Survey Says

TUESDAY, Feb. 3, 2015 (HealthDay News) -- One out of three adults would sooner face a shorter life span than take a daily pill to prevent heart disease, a new Internet survey found.

And about one in five would be willing to pay $1,000 or more to avoid taking that daily pill, the survey also found.

"There were a not-insignificant number of people who were ready to accept a large risk of death to avoid taking a pill for the rest of their lives," said lead author Dr. Robert Hutchins, a resident physician in the department of medicine at University of California, San Francisco. "Many patients are willing to say, 'I'd rather not do that, I'd rather risk the chance of death.' "

But while pills seemed to provoke a strong repulsion in some survey respondents, most simply shrugged and accepted the benefits over the inconveniences, the study found:

• 62 percent weren't willing to gamble any risk of immediate death over a daily pill.
• 70 percent said they wouldn't trade any weeks of their lives to avoid taking a heart pill every day.
• 43 percent said they wouldn't pay any amount of money to get out of taking a daily pill.

Hutchins declared himself more surprised over the large number of people who were willing to swallow the pill rather than risk death or endure expense.

"I was surprised at how many people said they weren't willing to risk death and they weren't willing to pay anything to avoid taking a daily pill," he said. "I was surprised that more people didn't say they would be willing to accept one out of 1 million odds to avoid taking the pill."

The survey, published Feb. 3 in the journal Circulation: Cardiovascular Quality and Outcomes, involved 1,000 people who were asked hypothetically via the Internet how much time they were willing to forfeit at the end of their lives to avoid taking daily medication. They also were asked about the amount of money they would pay and the hypothetical risk of death they were willing to accept to avoid taking a heart pill.

Hutchins and his colleagues wanted to assess the "utility value" of taking a pill -- the effect that the act of taking a pill every day has on a person's quality of life.

Such an assessment could be key to understanding why some people refuse to follow their doctor's orders on taking medication, even when it puts them at risk of serious disease and death, Hutchins said.

It also could have huge policy implications for American health care, he added. "We're talking about not a huge effect of quality of life on an individual, but the whole point is that you think about everyone who is taking these pills," he said. "When you multiply this small effect across millions of people, it can have a pretty big effect on the cost effectiveness of providing these medications."

Prior research conducted by Hutchins and his colleagues indicated that people who dislike taking pills most often object to the pill's physical aspects -- taste, smell and size. Some also said they didn't like the hassle involved with obtaining the medication.

"These are things we know influence people's dislike of pills, the feeling of a pill going down the throat, the size of the pill," Hutchins said. "We know there are characteristics of pills that are going to influence the responses people give us."

Donna Arnett is chair of epidemiology at the University of Alabama at Birmingham's School of Public Health, and a past president of the American Heart Association. She said doctors often struggle with the fact that a certain number of patients are not going to take the drugs that would save their lives.

"We know a large number of patients never refill their prescriptions after their first month's supply runs out," she said. "I was really impressed by how many people would not trade anything to go ahead and take the pill. That was the majority."

However, Arnett also noted that the average age of the survey participants -- 50 -- put them firmly in middle age, a time of life in which people start taking their health more seriously. In addition, more than 80 percent of them already were taking at least one medication daily.

Hutchins said the researchers will next dig into the minority "who are saying 'I don't care how much this helps me, I'm not going to do it', and figuring out why they feel that way."

The study was funded by the U.S. National Institutes of Health.

More information

For more on taking medications as prescribed, visit the U.S. Food and Drug Administration.