Treatment Engagement and Adherence: A Review of the Literature
Treatment adherence, taking prescription medications per prescribed instructions, is critical to realize the full clinical impact of therapies. Despite its importance, treatment non-adherence is both common and costly. There are numerous factors known to influence treatment adherence including social and economic, healthcare system, therapy-related, patient-related, and condition-related factors. Many factors are modifiable and may be a focus for multilevel interventions. When characterizing and improving treatment adherence, it is important to consider the three phases of adherence - initiation (beginning a new medication), implementation (extent to which a patient’s dosing matches what was prescribed), and discontinuation (stopping a medication for any reason). There may be unique opportunities to tailor materials and engage patients in their care at each phase. In this chapter, we describe the magnitude of the treatment non-adherence problem, discuss factors influencing treatment adherence, and describe selected scientific literature in the context of the three adherence phases.
