The impact of medication regimen factors on adherence to chronic treatment: a review of literature

Abstract

This article reviews recent literature in chronic illness or long-term health management including asthma, contraception, diabetes, HIV disease, and hypertension/cardiovascular disease, mental disorders, pain, and other diseases to determine the relationship between regimen factors and adherence to medications. The authors conducted an electronic literature search to detect articles published between 1998 and 2007. Articles were included if they pertained to a chronic illness or to contraception, included a clear definition of how adherence was measured, and included regimen factors as primary or secondary explanatory variables. Methodology of the studies varied greatly, as did methods of measuring adherence and regimen factors. Surprisingly few of these articles concerned (1) chronic treatment, (2) regimen factors such as dosing, pill burden, and regimen complexity, and (3) adherence measured in a clear manner. Most studies failed to use state-of-theart methods of measuring adherence. Despite these flaws, a suggestive pattern of the importance of regimen factors, specifically dose frequency and regimen complexity, emerged from this review.

The causes of low adherence in patients with antihypertensive therapy

“…Similar to other studies also our data suggested that especially older men suspected lower adherence in treatment of prescribed medications [18]. As solution was suggested to choose medication with longer elimination of half period in this situation, which could allow patients with low adherence to reach optimal therapeutic efficiency [19].…”

Measuring Pharmacy Performance in the Area of Medication Adherence: Addressing the Issue of Risk Adjustment

“…7 These findings and findings from other studies of the predictors of medication adherence [8][9][10][11][12][13][14][15][16] suggest a need to risk adjust for patient characteristics while computing adherence-based pharmacy quality scores. Failure to do so may result in comparisons that do not accurately reflect the effect of individual providers and rewards or penalties in pay-for-performance programs or other incentive/disincentive arrangements that may be reflective of the patient pool rather than pharmacy performance.…”

A Qualitative Study of Patient Perspectives about Hypertension

“…These include lack of patient knowledge, difficulty of treating an asymptomatic condition, personal beliefs that conflict with hypertension treatment goals, and other patient issues such as social economic status, cultural beliefs, access to care, psychosocial factors, and health literacy [5]. Additional obstacles include a lack of communication and trust between patients and care providers, high medication costs, high drug burden, failure to attend follow-up appointments, and discontinuation of therapy due to drug side effects [5][6][7][8][9][10]. There is limited data available about patients' personal perspectives regarding obstacles to hypertension control [11,12].…”