Ikkeadherence

Ikkeadherence, or nonadherence, is the extent to which a patient does not follow a prescribed medical regimen, including medications, lifestyle advice, and follow-up care. It can involve skipping doses, incorrect dosing, stopping therapy early, not refilling prescriptions, or missing appointments. Primary nonadherence means never filling the prescription; secondary nonadherence refers to not following the regimen after filling it. Intentional vs unintentional distinctions are common.

Nonadherence is common in chronic diseases and is linked to poorer disease control, more complications, higher hospitalization risk, and greater costs. Rates vary by condition and measurement method, but substantial nonadherence is widely reported for hypertension, diabetes, COPD, HIV, and mental health conditions.

Causes are multifactorial, including patient beliefs, health literacy, side effects, complexity of regimens, polypharmacy, costs, access barriers, and poor patient–provider communication. Factors can be intentional (deciding to skip) or unintentional (forgetfulness, misunderstanding).

Measurement relies on self-report, pharmacy data, pill counts, electronic monitoring, or drug levels, each with limitations. Interventions to improve adherence include simplifying regimens, fixed-dose combinations, once-daily dosing, reminders, and digital tools; patient education; motivational interviewing; and coordinated care from physicians, pharmacists, and nurses. Tailored approaches that address specific barriers and shared decision-making tend to be most effective.