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Patient adherence to treatment: three decades of research. A comprehensive review

19 December 2022

Low susceptibility to prescribed medical interventions is an ever-present and complex problem, especially for patients with chronic disease. With the increase in the number of medications that cause more benefit than harm when taken as prescribed, low susceptibility to treatment is a serious problem in healthcare. Relevant research has been obtained through a comprehensive search of various database systems to enable accurate assessment of major problems in terms of compliance with recommended medical interventions. The term compliance is the main term used in this review, as most peer-reviewed articles use this term. It has been three decades since the first workshop on compliance studies. It is time to stop and reflect on the accumulated knowledge. The vast number of quantitative studies conducted are of varying methodological quality, with no gold standard for measuring compliance, and it is often unclear what type of non-compliance is being investigated. In studies concerning compliance often absent is the patient, although the compliance model points to the importance of patient consent and harmony in the doctor-patient relationship. The basis of the compliance model is the patient as decision-maker, and the cornerstone is professional empathy. Recently, some qualitative research has identified important issues such as the quality of the doctor-patient relationship and the patient's health beliefs in this context. As non-adherence remains a major health problem, more high-quality studies are needed to assess these aspects, and systematic reviews / meta-analyses are required to investigate the effects of adherence in increasing the effects of interventions.

https://www.mayoclinicproceedings.org/action/showPdf?pii=S0025-6196%2811%2960007-4