Progress and Compliance in Alcohol Abuse Treatment

Improving patient compliance with physicians’ treatment or prescription recommendations is an important goal in medical practice. This paper examines the causal relationship between treatment progress and patient compliance. We hypothesize that patients balance expected benefits and costs during a treatment episode when deciding on compliance; a patient is more likely to follow medical advice if doing so results in an expected net gain in his welfare or health benefit. We use a unique data set of outpatient alcohol abuse treatment to identify a causal effect between treatment progress and compliance. Treatment progress is measured by the clinician’s comments after each attended visit. Compliance is measured by a client attending a scheduled appointment, as well as continuing with the treatment episode. We find that a patient making progress is less likely to drop out of treatment. However, we find no evidence that treatment progress raises the likelihood of a patient attending the next scheduled visit. Our results are robust to controls for unobserved patient heterogeneity.