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Adherence to Medical Treatment

Jacqueline Dunbar-Jacob, Ph.D., R.N.
University of Pittsburgh

Approximately 50% of persons with chronic disorders fail to take pharmacologic therapy as prescribed, leading to unnecessary disease complications, disease progression, including premature death, reduced functional abilities and quality of life, as well as to substantial costs to the health care system. While the problem has been noted for at least three decades, limited progress has been made in reducing these rates. Yet the importance of improved adherence to drug therapies remains. Identifying poor adherence is one problem. Data suggest that patients may not be aware of the extent of their dosage omissions and excesses while health care professionals are also unlikely to accurately identify adherence problems among patients. Newer measurement methodologies may aid in the identification of such problems. Predicting who is likely to be the poor adherer is a second problem. The data are varied between studies and may be related to both the range of problems which impact upon the ability to adhere as well as to the method of measurement used in the studies. A third problem is related to the limited number of studies which have adequately tested interventions designed to prevent or to remediate adherence problems. Attention continues to be needed to identify and to intervene with adherence problems in the interest of improving hypertension control.

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