Why Do We Not Follow Advice?

Have you ever been given sound advice and disregarded it, only to regret it later? Have you been diagnosed with a disease, been prescribed medication, and fail to take it as prescribed? Have you been given step by step instructions for constructing a piece of furniture or a recipe, only to throw out the directions and wing it? As it turns out, this is a common human phenomenon. What’s up with this noncompliance or refusal to adhere to instructions?

There are few consequences for refusing to follow directions on assembling a piece of furniture or follow a recipe. However, there can be severe consequences for medical noncompliance. A third of people will not fill their prescription, and half of the remaining group will fill it but will not take their medication correctly. They’ll miss doses, stop it prematurely, or not take it at all. Medication noncompliance is responsible for 10% of all hospitalizations in the US and costs the health care system up to $289 billion per year.

Interestingly, a study found that US women are more likely than men to be noncompliant with medications for even serious diseases like heart failure and HIV. This has consequences for women’s health. We tend to be compliant when it comes to others, but not ourselves. If a child or a pet is in your care, you follow directions as prescribed. Twenty percent of women said they were more likely to follow the prescription plan for their pet than for themselves. But when it comes to self care, humans are more likely to fail.

Some medication noncompliance is the fault of the prescriber but the vast majority will fail of their own accord due to their environment or lack of resources. You cannot expect someone to fully comply if they have to choose between food, housing and medication. Or perhaps they distrust doctors. Or simply fail to understand the necessity of the medication.

There are many factors that affect adherence. These include having the intellectual ability to understand what is being advised and it fits your belief system. If you have a belief about the subject that runs counter to the advice given, you will act according to your own beliefs. You need sufficient memory to follow through on the advice. Confusion may follow too much detailed information. If you don’t respect or trust the opinion of the advice giver, you won’t follow their advice. There are certain personality traits that lend themselves to non adherence. Contrary, stubborn, passive-aggressive, and conduct disordered people will not easily accept the advice of others.

Admittedly, not everyone gives good advice. Michael Hyatt says “Never take advice from people who aren’t getting the results you want to experience.”

Jordan Peterson, in his book 12 Rules for Life, says “Treat yourself like someone you are responsible for helping.” He also says “Just take the damn medicine.”