Problematic issues and development of classifications of the main parameters of quality and adherence to pharmacotherapy. Part I: Patient adherence to treatment

Abstract

The problem of patient adherence to treatment remains one of the most relevant for healthcare in most countries of the world. The solution of this problem is hindered by a number of reasons: no unified terminology, a "gold standard" for adherence assessment, and a universal standardized tactic for improving patient adherence to treatment. Despite the long history of research and a huge number of publications on adherence to therapy, there is still no classification of its types studied to date. In this regard, the purpose of this review and analytical work was to collect information on the main types of adherence/non-adherence identified to date and to develop, based on these data, a classification of adherence/non-adherence of patients to treatment. The search for literary sources was carried out by keywords. The analysis included publications for the last 20 years — 2003-2023. The categories of adherence were selected for the classification, relevant from the point of view of the general medical approach to the problem, the assessment of which is possible in real clinical practice. All types of adherence were grouped according to the leading feature. The developed classification of adherence/non-adherence of patients to treatment can serve as an additional tool for assessing adherence, which in the future may be useful in choosing strategy and possible ways to increase patients’ adherence to medical recommendations.