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N Engl J Med ; August 4, DOI: Both terms are imperfect and uninformative descriptions of medication-taking behavior. Unfortunately, applying these terms to patients who do not consume every pill at the desired time can stigmatize these patients in their future relationships with health care providers. The language used to describe how patients take their medications needs to be reassessed, but these terms are still commonly used. Rates of adherence for individual patients are usually reported as the percentage of the prescribed doses of the medication actually taken by the patient over a specified period. Some investigators have further refined the definition of adherence to include data on dose taking taking the prescribed number of pills each day and the timing of doses taking pills within a prescribed period. Adherence rates are typically higher among patients with acute conditions, as compared with those with chronic conditions; persistence among patients with chronic conditions is disappointingly low, laila majnu islam 800 most dramatically after the first six months of therapy. Some trials consider rates of greater than 80 percent to be acceptable, whereas others consider rates of greater than 95 percent to be mandatory for adequate adherence, particularly among patients with serious conditions laila majnu islam 800 as infection with the human immunodeficiency virus HIV. Although data on adherence are often reported as dichotomous variables adherence vs. Furthermore, successful interventions generally are substantially complex and costly. Even today, patients' self-reports can simply and effectively measure adherence. Each method has advantages and disadvantages, and no method is considered the gold standard. Direct approaches are expensive, burdensome to the health care provider, and susceptible to distortion by the patient. However, for some drugs, measuring these levels is a good and commonly used means of assessing adherence. For instance, the serum concentration of antiepileptic drugs such as phenytoin or valproic acid will probably reflect adherence to regimens with these medications, and subtherapeutic levels will probably reflect poor adherence or suboptimal dose strengths.



Adherence to Medication — NEJM
Adherence to Medication — NEJM
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