Treatment of chronic diseases usually involves long-term use of pharmacotherapy. Although these medications are effective in controlling disease, the full benefits are often not obtained because approximately 50% patients do not take their medication as prescribed. Factors contributing to poor medication adherence are myriad and include those related to patients (e.g., suboptimal health knowledge and lack of involvement in treatment decisions), those related to physicians (e.g., prescribing complex treatment regimens, communication barriers, ineffective communication of adverse effects and provision of care by multiple physicians), and those related to health systems (e.g., limitations on office visit times, limited access to care, lack of health information technology). As the barriers to medication adherence are complex and diverse, solutions to improve adherence must be multifactorial. To assess general aspects of medication adherence using cardiovascular disease as an example, a MEDLINE literature search (1 January 1990 to 31 March 2010) was conducted using the following search terms: cardiovascular disease, health literacy, medication adherence and pharmacotherapy. Manual sorting of 405 retrieved articles to exclude those that did not address cardiovascular disease, medication adherence or health literacy in the abstract yielded 127 articles for review. Additional references were obtained from citations of retrieved articles. This review reviews the findings from the identified articles and presents various strategies and resources to improve medication adherence.
