Psychological and ethical issues relating to medication non-adherence in patients with chronic disease

Treatment or medication non-adherence (MNA) is a far-reaching challenge to clinical practise that has a significant negative impact on treatment effectiveness and compromises the health and economic outcomes for both individuals and society. Lack of adherence to recommended therapeutic regimens reduces the effectiveness of treatment and may subsequently lead to disease progression, disabilities or death. Many studies have emphasized the magnitude of MNA and its effect on treatment outcomes, the patient’s health, on healthcare professionals and the associated costs. However, non-adherence is still common in clinical practice and no significant changes have been reported in recent years despite various research studies attempting to address and highlight the issue. MNA remains a major concern that is highly prevalent amongst medication-taking patients with chronic disease. Among the reported factors that may result in MNA practices are socioeconomic-related factors, factors related to the healthcare system, patient- or disease-related factors and treatment-related factors. The importance of ethical interventions cannot be understated and as such, MNA can be seen to be a multi-dimensional phenomenon which requires a far-reaching and multi-targeted solution. Several key areas in improving the rates of medication adherence are discussed and future foci in this area of research are identified.