A pharmacist's essay in STAT argues that the usual reasons people give for stopping a medicine are often the easy ones, and the studies she links to carry numbers her essay leaves out.
The short answer: forgetting and side effects are real, but they are not the only reasons. Research finds that how much people believe they need a medicine, and how much it worries them, tracks with whether they take it. Newer research looks at identity: what it means to need a pill every day. If that sounds familiar, say it to your prescriber.
What the essay says
In "I thought I knew why patients stopped taking their medicine. I was wrong," in STAT First Opinion on October 16, 2026, Marcela Gottschald, a Brazilian journalist and pharmacist based in Argentina, recalls her years as a clinical pharmacist. Patients first told her they forgot or had side effects. After longer conversations, she writes, other reasons came out:
- Fear of dependence. Needing treatment every day "felt like losing control over their own bodies."
- Proving you can cope. Some stopped temporarily "to prove to themselves that they could still function without it."
- Feeling changed. In mental health care, some believed the medicine changed who they were.
- Strength. For one young transplant patient, a daily medicine seemed to clash with his idea of adulthood.
- A daily reminder. A pill can become "a daily reminder that they are living with chronic illness."
Her conclusion: "I forgot" was sometimes "an easier answer, both for the patient and for the health care professional."
The numbers behind the links
Gottschald links four papers but quotes no figures. Here is what each reports, plus the CDC's national picture.
Beliefs about need and worry. A 2013 PLOS One meta-analysis led by Rob Horne pooled 94 studies of 25,072 patients with long-term conditions, from asthma to HIV to organ transplants. People who felt a stronger need for their medicine were more likely to take it (odds ratio 1.742), and people with more concerns about it were less likely (odds ratio 0.504). In the authors' terms, each standard-deviation rise in need beliefs raised the odds of adherence by a factor of 1.7; each rise in concerns lowered them by a factor of 2.0.
Reasons that form before the first dose. A 2018 systematic review by Shan-Qi Lee and colleagues studied "primary nonadherence": a new prescription never picked up or started. Of the 22 studies it included, 19 (86.4%) addressed patient factors, and the authors call patients' perceptions of a medicine's effectiveness, risks, and necessity "a predominant reason."
Illness identity. A systematic review by Caitlin Shneider, Abigail Robbertz, and Lindsey Cohen included 12 papers and found "moderate evidence" linking how people fold an illness into their identity with adherence and health outcomes. The abstract gives no pooled effect size.
Catching it early. A 2024 Health Psychology Review paper by Sarah Chapman, John Weinman, and colleagues proposes a framework rather than new data. In its full text, the authors, citing a 2003 WHO report, put the share of patients worldwide who do not take medicine as prescribed at 30 to 50%, and cite meta-analyses estimating that approximately a quarter of patients never start a prescribed treatment.
How common this is in the US. A 2017 CDC Grand Rounds report in MMWR says approximately "one in five new prescriptions are never filled," and approximately 50% of those filled are taken incorrectly. Multiply the two and 40.0% of new prescriptions end up filled and taken as directed, a rough figure built on two approximations. The CDC lists "beliefs and attitudes about their disease" alongside cost and side effects as reasons people decide to stop.
What the research does and does not show
- Beliefs predict adherence; identity is less settled. The Horne meta-analysis is large, but 81.9% of its studies were cross-sectional and 88.3% relied on self-reported adherence, so it shows a link, not cause. The identity review is small and gives no single number.
- Records can't hear reasons. In the Lee review, 20 of 22 studies were quantitative, drawing mostly on electronic medical and pharmacy records. The authors name this as a limitation: because the reasons are largely psychosocial, those records can't fully explain why people don't start.
- None of it is about your medicine. The studies span many conditions and do not say whether stopping is safe. Gottschald describes harms she saw after stops, including psychotic episodes, withdrawal, and transplant rejection.
How to raise it with your prescriber
Gottschald writes that asking only about side effects or missed doses gets answers that are "true but incomplete." She suggests clinicians ask what a medicine means to the patient. You can open that conversation yourself:
- "I don't like needing this every day. Can we talk about why I'm on it?"
- "I've wondered whether I'd be fine without it."
- "I feel different on this, and not just side effects."
- "Every dose reminds me I'm sick."
The Horne team writes that taking account of patients' need beliefs and concerns could help clinicians engage patients in treatment decisions.
Where Temi fits
A renewal is a moment you choose to stay on a medicine. At Temi, renewals are never automatic: you submit each request yourself, and the renewal questions include how the medication has been working for you. That answer goes to the licensed physician who reviews your request within 48 hours, often sooner. If something has changed, including how you feel about taking it, that is the place to say so. A renewal review costs $15 per medication, or $0 with Temi Care, and you pay your pharmacy for the medication. Temi serves patients located in Arizona, California, Colorado, Delaware, Florida, Michigan, Missouri, New York, North Carolina, Ohio, Pennsylvania, Texas, and Wisconsin, and does not prescribe controlled substances. See how refills work.
Sources
- Marcela Gottschald, "I thought I knew why patients stopped taking their medicine. I was wrong," STAT First Opinion, October 16, 2026. https://www.statnews.com/2026/10/16/nonadherence-medication-stopped-identity-pharmacist-side-effects-prevent/ (checked 2026-10-18)
- Horne R, Chapman SCE, Parham R, et al. "Understanding Patients' Adherence-Related Beliefs about Medicines Prescribed for Long-Term Conditions: A Meta-Analytic Review of the Necessity-Concerns Framework." PLOS One, December 2, 2013. https://pmc.ncbi.nlm.nih.gov/articles/PMC3846635/ (checked 2026-10-18)
- Lee SQ, Raamkumar AS, Li J, et al. "Reasons for Primary Medication Nonadherence: A Systematic Review and Metric Analysis." Journal of Managed Care & Specialty Pharmacy, August 2018. https://pmc.ncbi.nlm.nih.gov/articles/PMC10397746/ (checked 2026-10-18)
- Shneider CE, Robbertz AS, Cohen LL. "A Systematic Review of Relationships Between Illness Identity and Health-Related Outcomes in Individuals with Chronic Illnesses." Journal of Clinical Psychology in Medical Settings, March 2024 (online September 26, 2023). https://pubmed.ncbi.nlm.nih.gov/37751072/ (checked 2026-10-18)
- Chapman S, Frostholm L, Chalder T, et al. "Preventing medication nonadherence: a framework for interventions to support early engagement with treatment." Health Psychology Review, December 2024 (online August 5, 2024). https://pubmed.ncbi.nlm.nih.gov/39101263/ and full text https://www.tandfonline.com/doi/full/10.1080/17437199.2024.2385525 (checked 2026-10-18)
- Neiman AB, Ruppar T, Ho M, et al. "CDC Grand Rounds: Improving Medication Adherence for Chronic Disease Management — Innovations and Opportunities." MMWR, November 17, 2017. https://www.cdc.gov/mmwr/volumes/66/wr/mm6645a2.htm (checked 2026-10-18)
- Temi refill service page. https://usetemi.com/prescription/refills (checked 2026-10-18)
