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Nonadherence in asthmatic patients: is there a solution to the problem?
1Department of Pediatrics, National Jewish Medical and Research Center, Denver, Colorado, USA.
Summary
Patient adherence to medication remains poor, with about half of prescribed drugs taken. Addressing nonadherence requires understanding its causes and implementing system-supported interventions within the patient-caregiver relationship for better treatment outcomes.
Area of Science:
- Pharmacology and Therapeutics
- Health Services Research
- Patient Adherence Studies
Background:
- Patient adherence to prescribed medical treatment is a persistent challenge in healthcare.
- Nonadherence significantly impacts treatment outcomes, patient well-being, and healthcare costs.
Purpose of the Study:
- To review the relationship between adherence and treatment outcomes.
- To explore the causes, measurement methods, and intervention strategies for nonadherence.
Main Methods:
- Systematic review of articles on adherence to asthma therapy.
- MEDLINE database search (1990-1997) using relevant keywords.
- Selection of pertinent articles, prioritizing controlled studies.
Main Results:
- No significant improvement in adherence rates; patients average 50% medication intake.
- Objective measurement is most accurate for assessing nonadherence.
- Nonadherence leads to patient suffering, increased costs, and compromised clinical trial results.
- Causes of nonadherence are multifactorial, involving disease, treatment, patient, and system factors.
Conclusions:
- Improved adherence enhances disease control, contingent on healthcare systems supporting resource allocation for barrier negotiation.
- Interventions outside the patient-caregiver relationship are less effective.
- Targeted programs for challenging patients are necessary for behavioral change, promising improved health and cost savings.
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