Factor | Influence on adherence | Reference |
Medication | ||
Regimen | ↓ ↓ | Farmer 1999,21 Sacket 1976,36 Rand 2005,35 Rapoff 200616 |
Lengthier and more complicated | ||
Polypharmacy* | ||
Duration | ↓ | |
Long term | ||
Type | ↓ | |
Not have medication direct effect | ||
Administration | ↓ | Garcia-Aymerich 2000,40 James 1985,38 Tashkin 199534 |
Inhaler | ||
Cost | ↓ | Hughes 2004,19 Soumerai 199143 |
Inability to pay or reduce access | ||
Adverse effects | ↓ | Col 199042 |
Patient | ||
Old age | ↑ | Rand 199528 |
Comorbidity including anxiety and depression | ↓ | Cully 2006,46 Hughes 2004,19 Morris 199286 |
Cognitive defect | ↓ | Incalzi 199744 |
Difficulty reading | ↓ | Zuccollo 198545 |
Perception of the disease | ↓ ↑ | DiMatteo,12 Rapoff 200616 |
Lack of regular symptom | ||
Affect daily activities and anticipate problem | ||
Perception or social support | ↑ | Tashkin 199534 |
Stable family life and caregiver | ||
Health care provider | ||
Type of physician | ↑ | Lau 199648 |
Specialist | ||
Type of care and service | ↑ ↑ | Tashkin 199534 |
Continuity of care follow-up and written supervision | ||
Written instruction | ||
Self-management with positive reinforcement | ↑ | Turner 1995,15 Dunbar 197952 |
*Polypharmacy has not always proven to be associated with decreased adherence.
†Older age may be associated with greater number of comorbid conditions, cognitive defect and difficulty reading, which reduces adherence.