Patel Sheena, Huang Mingyi, Miliara Sophia
Swedish Orphan Biovitrum AB, 113 64 Stockholm, Sweden.
Apellis Pharmaceuticals Inc., Waltham, MA 02451, USA.
J Clin Med. 2025 Aug 26;14(17):6034. doi: 10.3390/jcm14176034.
Adherence to medications is a significant challenge in chronic disease management. Poor adherence can lead to adverse patient outcomes including disease progression, increased morbidity, reduced quality of life, higher hospitalization rates, increased medical costs, and mortality. Medical adherence is a complex issue, influenced by multiple factors, including patient-related, medication-related, and healthcare system-related barriers. This review explores reasons for both intentional non-adherence, such as patients underestimating the consequences of the disease, inadequate education or poor healthcare provider-patient communication, and unintentional non-adherence, including forgetfulness, pathophysiological barriers, socioeconomic barriers (including lifestyle and patient factors), or healthcare resource limitations. Multifaceted, patient-tailored interventions that could improve adherence are discussed, including promoting health education, enhancing healthcare provider-patient engagement, and exploring alternative medical solutions and emerging technological advances. No single approach fits all; this review aims to deepen the understanding of intentional and unintentional non-adherence and to inform targeted interventions to empower patients, foster trust, and improve adherence for those with chronic conditions.
药物依从性是慢性病管理中的一项重大挑战。依从性差会导致不良的患者结局，包括疾病进展、发病率增加、生活质量下降、住院率升高、医疗成本增加以及死亡率上升。药物依从性是一个复杂的问题，受多种因素影响，包括与患者相关、与药物相关以及与医疗保健系统相关的障碍。本综述探讨了故意不依从的原因，例如患者低估疾病后果、教育不足或医护人员与患者沟通不畅，以及非故意不依从的原因，包括遗忘、病理生理障碍、社会经济障碍（包括生活方式和患者因素）或医疗资源限制。文中讨论了可以提高依从性的多方面、针对患者的干预措施，包括促进健康教育、加强医护人员与患者的互动，以及探索替代医疗解决方案和新兴技术进展。没有一种方法适用于所有人；本综述旨在加深对故意和非故意不依从的理解，并为有针对性的干预措施提供信息，以增强患者能力、增进信任并提高慢性病患者的依从性。
