Adherence to treatment – an important part of reaching therapeutic effects on chronic conditions

Authors: Ján Gajdošík
Authors‘ workplace: Všeobecná ambulancia pre dospelých, Nové Zámky
Published in: AtheroRev 2017; 2(1): 15-19
Category: Reviews


Cardiovascular diseases, particularly hypertension, diabetes mellitus, dyslipidemia in recent decades become a major cause of the increase in morbidity and mortality is a major problem in health systems around the world. Despite the gradual improvement of quality of health care, the pursuit of increased awareness of the professional and general public do not achieve the expected results in improving the health status of the population. The causes are manifold, one from the most important is the non-adherence that WHO has identified as a major problem of population health, and important modifiable factor that reduces the effectiveness of treatment and negatively notes the health status of the population, is a significant increase in costs.

Key words:
adherence, adherence physician to guide line, evaluation of adherence, nonadherence, persistence, non-adherence prevention


1. Adherence To Long Term Therapies: Evidence for Action. World Health Organization: Geneva 2003. ISBN 92 4 154599 2. Dostupné z WWW: <>.

2. Barofsky I. Compliance, adherence and the therapeutic alliance: steps in the development of self care. Soc Sci Med 1978; 12(5A): 369–376.

3. Treharne GJ, Lyons AC, Hale ED et al. Predictors of medication adherence in people with rheumatoid arthritis: studies are necessary but non validated measures of medications are of concern. Rheumatology (Oxford) 2005; 44(10): 1330.

4. Kalamazov J. National prescription survey conducted for the Upjohn Company by Market Facts. Michigan 1985.

5. Vawter L, Tong X, Gemilyan M et al. Barriers to Antihypertensive Medication Adherence Among Adults-USA 2005. J Clin Hypertens (Greenwich) 2008; 10(12): 922–929. Dostupné z DOI: <–7176.2008.00049.x>.

6. Vermeire E, Hearnshaw H, Van-Royen P et al. Patient adherence to treatment: three decades of research. A comprehensive review. J Clin Pharm Ther 2001; 26(5): 331–342.

7. Grol R, Berwick D, Wensing M. On the trial of quality and safety in health care BMJ 2008; 336(7635): 74–76. Dostupné z DOI: <>.

8. Laššánová M,Laššán Š, Kriška M et al. Percepcia rizika liečby a adherencia lekárov k sekundárnej farmakoterapii po infarkte myokardu. Klinická farmakologie a farmacie 2008; 22(3): 94–98.

9. Nicolucci A, Kovacs Burns K, Holt RI et al. Diabetes Attitudes, Wishes and Needs second study (DAWN2™): cross-national benchmarking of diabetes-related psychosocial outcomes for people with diabetes Diabet Med 2013; 30(7): 767–777. Dostupné z DOI: <>. Erratum in Diabet Med 2013; 30(10): 1266.

10. Caro JJ, Speckman JL, Salas M et al. Effect of initial drug choice on persitence with antihypertensive therapy, the importance of actual practice data. CMAJ 1990; 160(1): 41–46.

11. Elzubier AG, Husain AA, Suleiman IA et al. Drug compliance among hypertensive patient Kassala, eastern Sudan. East Mediterr Health J 2000; 6(1): 100–105.

12. Psaty BM, Koepsell TD, Wagner EH et al. The relative risk of incident coronary disease associated with recenntly stoping the use of beta blockers. JAMA 1990, 263(121): 1653–1657.

13. Mokáň M, Martinka E, Galajda P. Diabetes mellitus a vybrané metabolické ochorenia. P + M: Turany 2008. ISBN 978–80–969713–9–8.

14. Kerr EA, Gerzoff RB, Krein SL et al. Diabetes care quality in the Veterans Affairs Health Care System and commercial managed care: the TRIAD study. Ann Intern Med 2004; 141(4): 272–281.

15. Lee WC, Balu S, Cobden D et al. Prevalence and economic consequences of medication adherence in diabetes: a systematic literature review. Manag Care Interface 2006; 19(7): 31–41.

16. Liebl A, Neiss A, Spannheimer A et al. Costs of type 2 diabetes in Germany. Results of the CODE-2 study. Dtsch Med Wochenschr 2001; 126(20): 585–589.

17. Lau DT, Nau DP. Oral antihyperglycemic medication nonadherence and subsequent hospitalization among individuals with type 2 diabetes. Diabetes Care 2004; 27(9): 2149–2153.

18. Salas M, Hughes D, Zuluaga A et al. Costs of medication nonadherence in patients with diabetes mellitus: a systematic review and critical analysis of the literature. Value Health 2009; 12(6): 915–922. Dostupné z DOI: <http://dx.doi.org10.1111/j.1524–4733.2009.00539.x>.

19. Ford I, Murray H, Packard CJ et al. Long-term follow-up of the West of Scotland Coronary Prevention Study. N Engl J Med 2007; 357(15): 1477–1486.

20. Benner JS, Glynn RJ, Mogun H et al. Long-term persistence in use of statin therapy in elderly patients. JAMA 2002; 288(4): 455–461.

21. Ho PM, Magid DJ, Shetterly SM et al. Medication nonadherence is associated with a broad range of adverse outcomes in patients with coronary artery disease. Am Heart J 2008; 155(4): 772–779. Dostupné z DOI: <>.

22. Shah ND, Dunlay SM, Ting HH et al. Long-term medication adherence after myocardial infarction: experience of a community. Am J Med 2009; 122(10): 961.e7–e13. Dostupné z DOI: <>.

23. Glader EL, Sjölander M, Eriksson M et al. Persistent use of secondary preventive drugs declines rapidly during the first 2 years after stroke. Stroke 2010; 41(2): 397–401. Dostupné z DOI: <>.

24. McCombs JS, Nichol MB, Newman CM et al. The costs of interrupting antihypertensive drug therapy in a Medicaid population. Med Care 1994; 32(3): 214–226.

25. Flack JM, Casciano R, Casciano J et al. Cardiovascular disease costs associated with uncontrolled hypertenzion. Manag Care Interface 2002; 15(11): 28–36.

26. Garner JB. Problems of nonadherence in cardiology and proposals to improve outcomes. Am J Cardiol 2010; 105(10): 1495–1501. Dostupné z DOI: <>.

27. Kangas T, Reunanen A, Koivisto V et al. Direct costs of health care of drug-treated diabetic patients in Finland in 1989. In: Kangas T. The FinnDiab Report. Health care of people with diabetes in Finland. Addendum. 1995. Dostupné z WWW: <>.

28. Henriksson F, Agardh CD, Berne C et al. Direct medical costs for patients with type 2 diabetes in Sweden. J Intern Med 2000; 248(5): 387–396.

29. Herman WH, Eastman RC.The effects of treatment on the direct costs of diabetes. Diabetes Care 1998; 21(Suppl 3): C19-C24.

30. Balkrishnan R, Rajagopalan R, Camacho FT et al. Predictors of medication adherence and associated health care costs in an older population with type 2 diabetes mellitus: a longitudinal cohort study. Clin Ther 2003; 25(11): 2958–2971.

31. [DCCT Research Group. 1995]. The effect of intensive diabetes therapy on the development and progression of neuropathy. The Diabetes Control and Complications Trial Research Group. In: Ann Intern Med 1995; 122(8): 561–568.

32. Chubb B, Valentine WJ, Twena N et al. 2006. Improvements in clinical and economic outcomes associated with reaching different HbA1c tardets: a modeling study of type 2 diabetes in the UK. Diabetologia 2006; 49(Suppl 1): 22- 23.

33. Peterson A, McGhan W. Pharmacoeconomic impact of non-compliance with statins. Pharmacoeconomics 2005; 23(1): 13–25.

34. Lardizabal JA, Deedwania PC. Benefits of statin therapy and compliance in high risk cardiovascular patients. Vasc Health Risk Manag 2010; 6: 843–853. Dostupné

35. z DOI: <>.

36. Brown SA. Interventions to promote diabetes self-management: state of the science. Diabetes Education, 1999; 25(6 Suppl): S52–S61.

37. Kinmonth AL, Woodcock A, Griffin S et al.Randomized controlled trial of patient centred care of diabetes in general practice: Impact on current wellbeing and future disease risk. The Diabetes Care from Diagnosis Research Team. BMJ 1998; 317(7167): 1202–1208.

38. Rovný I. Determinanty zdravia: Slovensko na začiatku XXI. storočia. 2009. Dostupné z WWW: <–3/determinanty_zdravia1.htm>.

Angiology Diabetology Internal medicine Cardiology General practitioner for adults
Forgotten password

Don‘t have an account?  Create new account

Forgotten password

Enter the email address that you registered with. We will send you instructions on how to set a new password.


Don‘t have an account?  Create new account