Adherence Matters: The Critical Role Of Healthcare Professionals In Improving Patient Outcomes

Understanding the Science Behind Adherence

Despite remarkable advancements in the treatment of chronic diseases, complications and mortality rates continue to rise, posing a public health challenge of striking magnitude. Adherence rates remain low, with only 50% of patients in high-income countries and even lower in low- and middle-income regions like India.(1) In India, one in two diabetes (2) and cardiovascular disease (3) patients do not adhere to medications as directed. Additionally, an equal proportion of the Indian population fails to follow lifestyle changes, including dietary recommendations.(4)

In contrast, good adherence goes a long way in improving health outcomes, particularly in the case of chronic conditions. Patients who take medications as prescribed experience greater reductions in blood pressure and LDL cholesterol, lowering their risk of complications. Consistent adherence is linked to a 21% reduction in long-term mortality, fewer hospitalizations, and decreased healthcare costs. The evidence is clear- ensuring adherence is not just about following prescriptions but about preventing disease progression and saving lives.(5)

Barriers to Adherence: Why Do Patients Struggle?

Medication adherence is shaped by patient-related, provider-related, and systemic factors, each posing significant barriers. Many patients struggle due to a lack of knowledge about their condition and treatment, leading to intentional or unintentional non-adherence. Forgetfulness, irregular routines, and lifestyle disruptions further contribute to missed doses. Personal beliefs, including fears of dependency or side effects, often lead to self-adjusted medication use. Psychological factors such as stress, anxiety, and depression also reduce adherence, while physical limitations and complex regimens in patients with multiple conditions make consistent medication use more difficult.(6)

Time constraints in consultations and fragmented care from multiple sources can create confusion and reduce patient engagement. Systemic and socioeconomic barriers, including high medication costs, limited healthcare access, and medication shortages, prevent patients from maintaining their treatments. Social stigma, cultural beliefs, and work-related disruptions also interfere with adherence. These challenges highlight the need for targeted interventions that improve patient education, enhance healthcare communication, and address systemic gaps to ensure better adherence outcomes.(4)

The Doctor’s Role: Strategies for Enhancing Adherence

Given that provider-related factors significantly impact medication adherence, it is crucial for doctors to identify barriers and implement strategies to enhance patient understanding, engagement, and continuity of care.

Physicians can enhance adherence in their patients through education, technology, and regimen simplification. Clear communication, patient counseling, and shared decision-making improve engagement, ensuring patients understand treatment necessity. Digital tools like mobile apps, smart pill dispensers, and telemedicine provide reminders and real-time monitoring, reducing missed doses. (7) Simplifying regimens with once-daily dosing or combination therapies minimizes treatment burden and enhances compliance. (8)

In a setting like India, addressing financial barriers by prescribing cost-effective alternatives and utilizing assistance programs can improve accessibility and, hence, adherence. Behavioral strategies, including positive framing, habit-linking, and reinforcement techniques, further support adherence. A multidisciplinary approach involving pharmacists and nurses may also be required for continuous monitoring, patient support, and long-term treatment success. (9)

Call to Action: Leveraging World Adherence Day for Patient Engagement

Identifying the importance of Adherence in patients, global pharma Servier along with 15 global scientific associations and patient organizations such as World Heart Federation, European Society of Cardiology, European Society of Hypertension and many more, are observing the First World Adherence Day on the March 27, 2025 to enhance adherence and improve the management of cardiometabolic and venous diseases. This initiative calls for the critical role of healthcare professionals in promoting adherence.

Doctors can collaborate on the issue of adherence with just a simple yet powerful action: dedicate one minute in consultations to explain adherence’s impact, non-adherence risks, and the benefits of consistent treatment. Physicians can drive lasting behavioral change by converting this awareness into a pledge, empowering patients toward better health outcomes.

Key Messages:

• Only 50% of patients follow prescribed treatments, and in India, 1 in 2 diabetes and cardiovascular disease patients fail to take medications and follow lifestyle changes.
• Good adherence leads to 21% lower mortality, fewer hospitalizations, and reduced healthcare costs.
• Patients struggle due to beliefs, poor communication, high costs, and limited access to healthcare.
• Doctors can improve adherence through education, simplified regimens, digital tools, and cost-effective prescriptions—a one-minute talk can make a difference.

Ensuring adherence is not just about following prescriptions; it is a lifesaving intervention that reduces mortality, prevents complications, and improves long-term patient outcomes.

Disclaimer: This article is for educational and informational purposes only and is not intended as medical advice. While adherence to prescribed treatments plays a crucial role in improving health outcomes, patients should always be guided by personalized medical guidance through their Health Care Practitioners. Neither the authors nor the publishers assume any liability for its use.

References:

1. Kardas P, Bennett B, Borah B, et al. Medication non-adherence: reflecting on two decades since WHO adherence report and setting goals for the next twenty years. Front Pharmacol. 2024;15:1444012. Published 2024 Dec 23. doi:10.3389/fphar.2024.1444012

2. Medi RK, Mateti UV, Kanduri KR, Konda SS. Medication adherence and determinants of non-adherence among south Indian diabetes patients. J Soc Health Diabetes 2015;3:48-51.

3. Rani, Nutakki Tulasi Uma, et al. "Medication Adherence and Quality of Life among Cardiology Patients in Guntur." Journal of Drug and Alcohol Research, vol. 13, 2024, Article ID 236405, pp. 1–7. Ashdin Publishing, doi:10.4303/JDAR/236405.

4. Saleh, Farzana et al. “Non-adherence to self-care practices & medication and health related quality of life among patients with type 2 diabetes: a cross-sectional study.” BMC public health vol. 14 431. 7 May. 2014, doi:10.1186/1471-2458-14-431

5. Walsh CA, Cahir C, Tecklenborg S, Byrne C, Culbertson MA, Bennett KE. The association between medication non-adherence and adverse health outcomes in ageing populations: A systematic review and meta-analysis. Br J Clin Pharmacol. 2019;85(11):2464-2478. doi:10.1111/bcp.14075

6. Kvarnström, K.; Westerholm, A.; Airaksinen, M.; Liira, H. Factors Contributing to Medication Adherence in Patients with a Chronic Condition: A Scoping Review of Qualitative Research. Pharmaceutics 2021, 13, 1100. https://doi.org/10.3390/pharmaceutics13071100

7. Ezeamii VC, Okobi OE, Wambai-Sani H, et al. Revolutionizing Healthcare: How Telemedicine Is Improving Patient Outcomes and Expanding Access to Care. Cureus. 2024;16(7):e63881. Published 2024 Jul 5. doi:10.7759/cureus.63881

8. Religioni U, Barrios-Rodríguez R, Requena P, Borowska M, Ostrowski J. Enhancing Therapy Adherence: Impact on Clinical Outcomes, Healthcare Costs, and Patient Quality of Life. Medicina (Kaunas). 2025;61(1):153. Published 2025 Jan 17. doi:10.3390/medicina61010153

9. Duong, Jessica Q et al. “How can physicians improve medication adherence and outcomes in dermatological conditions?.” Expert review of pharmacoeconomics & outcomes research vol. 24,7 (2024): 799-806. doi:10.1080/14737167.2024.2370911