Take medication exactly as prescribed — don’t stop just because you feel better

People who consistently follow their doctor’s instructions when taking medication have roughly half the risk of dying during the same period compared to those who take it intermittently. This figure should be viewed with some caution. Even individuals who take fake pills consistently also have lower mortality rates, which suggests part of the benefit stems from the fact that people who stick to any medication routine tend to be more health-conscious overall. Still, the risks of skipping doses are well documented — especially for blood pressure drugs, anticoagulants, and anti-rejection medications.

There’s no cost at all; in fact, it saves money on future treatment for complications. Taking the pills each day takes only a few minutes. The real challenge is sticking to the regimen every single day.

This finding comes from a meta-analysis that pooled data from 21 separate studies involving 46,847 participants. Compared to those who took medication irregularly, people who followed their prescription exactly had roughly 44% lower risk of dying during the same timeframe. The raw odds ratio was 0.56, with a 95% confidence interval ranging from 0.50 to 0.63; this interval represents the range within which the true value is likely to fall. When only treatments with proven effectiveness were considered, the risk reduction was about 45% (odds ratio 0.55, 95% CI 0.49–0.62).

This is a somewhat controversial figure and one of the numbers in this guide that requires extra caution. In the same meta-analysis, individuals who consistently took placebos also showed a lower mortality rate (odds ratio 0.56, 95% CI 0.43–0.74). This indicates that a significant portion of the benefit is attributable to the “healthy adherer effect” — the tendency of people who stick to any kind of medication routine to generally maintain healthier habits. Nevertheless, the risks associated with discontinuing medication are very real, particularly for blood pressure drugs, anticoagulants, and anti-rejection medications.

Simpson SH, Eurich DT, Majumdar SR, et al. (2006). A meta-analysis of the association between adherence to drug therapy and mortality. BMJ, 333(7557), 15. https://doi.org/10.1136/bmj.38875.675486.55