Adherence to Long-Term Therapies - Evidence for Action
(2003; 211 pages) View the PDF document
Table of Contents
View the documentPreface
View the documentAcknowledgements
View the documentScientific writers
View the documentIntroduction
View the documentTake-home messages
Open this folder and view contentsSection I - Setting the scene
Open this folder and view contentsSection II - Improving adherence rates: guidance for countries
Close this folderSection III - Disease-Specific Reviews
Open this folder and view contentsChapter VII - Asthma
Open this folder and view contentsChapter VIII - Cancer (Palliative care)
Open this folder and view contentsChapter IX - Depression
Open this folder and view contentsChapter X - Diabetes
Open this folder and view contentsChapter XI - Epilepsy
Close this folderChapter XII - Human immunodeficiency virus and acquired immunodeficiency syndrome
View the document1. Types of nonadherence
View the document2. Challenges in assessing adherence
View the document3. Predictors of adherence
View the document4. A framework for interventions to increase adherence
View the document5. Conclusions
View the document6. References
Open this folder and view contentsChapter XIII - Hypertension
Open this folder and view contentsChapter XIV - Tobacco smoking cessation
Open this folder and view contentsChapter XV - Tuberculosis
Open this folder and view contentsAnnexes
Open this folder and view contentsWhere to find a copy of this book
 

2. Challenges in assessing adherence

It is easy for health professionals to miss adherence problems because patient self-reports of adherence tend to be exaggerated (20,21) due perhaps both to a recall bias and a desire to please the provider and avoid criticism. Some patients have been known to dispose of their medication before a scheduled check on their adherence to it so as to appear to have adhered (22). Inadequate adherence coupled with biased reporting is ubiquitous across medicine (23). Conversely, patients who report problems with adherence are rarely trying to mislead their providers (24).

In addition to the misreporting of adherence by patients, estimates of adherence made by health care providers are also usually over-optimistic (25,26).Moreover, providers of health care are not able to predict very accurately which patients will adhere. Many providers believe that factors associated with socioeconomic status, such as lack of education and poverty are good predictors of nonadherence. However, predictors of adherence vary greatly across populations and settings and no one factor has been consistently associated with nonadherence across all studies (27).

to previous section
to next section
 
 
The WHO Essential Medicines and Health Products Information Portal was designed and is maintained by Human Info NGO. Last updated: November 5, 2014