Physicians say patient compliance is getting worse, and they’re hearing more requests for generic or OTC alternatives to prescribed medications as the economic malaise takes its toll, according to a Pri-Med survey.

Of the 473 respondents, 70% said they are hearing patients increasingly request generic or OTC alternatives, and 68% said they’ve noticed an increase in non-compliant behaviors with regards to medication usage among patients. More than half said they’re seeing changes in patient payment, such as increased delinquencies or requests for payment plans, and 88% are seeing changes to patients’ appointment behaviors, including increased cancellations and refusals of tests or screening procedures.

As a result, clinicians reported spending more time with patients at the point of care discussing prescription alternatives or the importance of compliance and prevention. They’re also devoting more time to investigating lower-cost treatment options and formulary specifics to help out their patients, and more than three-quarters said they’re making changes to their practice such as taking steps to minimize cancellations, expanding payment options and offering online or phone-based consultations.

The web-based poll, conducted from May 14 to May 21, was emailed to more than 16,000 Pri-Med alumni clinicians and garnered a response rate of 3%, the company said.