Poor compliance has had a major impact clinically and certainly has a significant impact in terms of our ability to conduct reasonable research efforts. Research subjects who are not adherent to treatment protocols end up lowering the power of the study, suggesting that we need an increase in the sample size; it leads to overestimation of the safety of the treatment, and underestimation of risks and adverse effects, because individuals are not involved with treatment to the full extent; and potentially to an underestimation of the effectiveness of treatment itself; and overall increased cost of research studies.