- Non-adherence factors may be organized into five categories: socioeconomic, health care team and system-related, disease-related, therapy-related, and patient-related.
- Behavioral drivers of non-adherence are both intentional and unintentional.
- Despite extensive research, no single model has yet been shown to be highly accurate in predicting patient adherence.
Treatment adherence offers a significant opportunity for improved outcomes
As noted in previous articles, non-adherence to pharmacological treatments is common among patients with chronic conditions in general and with cardiovascular disease in particular. Non-adherence to medications is a major driver of poorer health outcomes, reduced quality of life, and wasted healthcare resources.1,2,3
The drivers of non-adherence are complex
Non-adherence is a complex issue, making it difficult for health care providers to know when and how to intervene. The World Health Organization has five classifications for non-adherence: socioeconomic, health care team and system-related, disease-related, therapy-related, and patient-related factors.4 Recent interventions using a variety of approaches to address have demonstrated efficacy. These approaches include providing information (individual or group education), behavioral aids (calendar reminders, pill boxes, coaching, etc.), and strategies for improving social support (e.g. family involvement).5,8 Despite extensive research by behavioral and clinical scientists to organize patient-related non-adherence, there is still no comprehensive and widely accepted model. As a result, effective, standardized, and reliable patient-focused interventions remain a significant area of opportunity to improve outcomes,6 and there are useful tools and approaches based on the known drivers of patient behavior that can use to improve adherence.