Medication adherence in adolescents: physiological, psychosocial, and clinical perspectives

Adolescence is a developmental stage characterized by significant physiological, psychological, and social changes. These changes are known to have a direct impact on medication use and adherence to treatment. Adolescents tend to have low adherence rates to treatment for chronic illnesses. When irrationally managed, this situation can lead to problems such as inadequate disease control, increased risk of complications, and increased use of healthcare services. The aim of this review is to evaluate the factors affecting medication adherence in adolescents, especially those specific to adolescents, considering the current literature and to suggest solutions. This review examines the implications of physiological and neurodevelopmental differences accompanying pubertal development on pharmacokinetic and pharmacodynamic processes. It also discusses the role of psychosocial factors such as the pursuit of autonomy, peer influence, aesthetic concerns, and performance anxieties on adherence during adolescence. Furthermore, changes in drug formulations and routes of administration, increased independence in accessing medications, and the transfer of treatment responsibility from parents to adolescents are evaluated. The potential contributions of digital health applications and mobile technologies to supporting adherence in adolescents are also addressed. Finally, recommendations aimed at increasing adherence through rational drug use in adolescents are presented. In conclusion, drug adherence in adolescents, which significantly determines the outcome of pharmacotherapy, is a complex process shaped by the interaction of numerous biological and psychosocial factors that requires holistic, developmentally appropriate approaches.