Adherence to Medication Improves Clinical Outcomes

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Lars Osterberg, M.D., and Terrence Blaschke, M.D.

Drugs don’t work in patients who don’t take them.
— C. Everett Koop, M.D.

Summary:

Poor adherence to medication regimens is common, contributing to substantial worsening of disease, death, and increased health care costs. Practitioners should always look for poor adherence and can enhance adherence by emphasizing the value of a patient’s regimen, making the regimen simple, and customizing the regimen to the patient’s lifestyle. Asking patients nonjudgmentally about medication-taking behavior is a practical strategy for identifying poor adherence. A collaborative approach to care augments adherence. Patients who have difficulty maintaining adequate adherence need more intensive strategies than do patients who have less difficulty with adherence, a more forgiving medication regimen, or both. Innovative methods of managing chronic diseases have had some success in improving adherence when a regimen has been difficult to follow. 99,125-127

New technologies such as reminders through cell phones and personal digital assistants and pillboxes with paging systems may be needed to help patients who have the most difficulty meeting the goals of a regimen.