THE COMPLEXITY OF ADHERENCE ISSUE: A REVIEW OF ITS SCOPE AND DETERMINANTS

Adherence is tremendously important for efficiency and safety of pharmacotherapy and has a significant influence on its clinical, economic and humanistic outcomes, which can be observed both on the individual level of the patient as well as on the overall healthcare system. The inadequate degree of adherence is a long-lasting and widely present problem which can have immense and long-term consequences. Therefore, the issue of adherence is a big challenge for medical professionals in clinical practice. The concept of adherence is based on cooperation between patients and medical team members in the process of therapy management. It is focused on patients and implies a two-way transfer of information, agreement and shared responsibility for success in realization of adequate therapy regime and defined goals. Although there are numerous methods for adherence assessment, the evaluation of this parameter is still considered problematic. The complexity of adherence can be seen in its multidimensionality since numerous factors which individually and in mutual interaction affect medicine-taking behavior and thus create a framework that determines the achieved level of adherence have been identified and analyzed. Considering the fact that poor adherence is one of the main preventable causes of unsatisfactory therapy results and excessive costs of medical care, it is evidently necessary to ensure a high quality base in the form of knowledge, skills and motivation at the healthcare system level for adherence evaluation and improvement, as well as a multidisciplinary approach based on coordinated activities of healthcare policy creators, researchers and medical professionals. Acta Medica Medianae 2016;55(1):51-58.