[Some considerations about adherence to therapy]

Abstract

Poor adherence to therapy is a proven cause of therapeutic failure, transversal to all areas of medicine with broad health and economic repercussions. There are many factors that can lead to inadequate adherence, currently also economic reasons. The evidence available from the intervention studies implemented to improve adherence in various clinical conditions offers disappointing results, particularly in chronic conditions where the interventions implemented were found to be complex and relatively ineffective. Poor adherence persists widely because it is a complex problem and resistant to generic approaches. In conditions of chronicity, where polypharmacy is frequent and the patient has difficulties to manage it adequately, an overall and long-lasting approach is required, involving a review of the whole therapy and, with the patient's involvement and consent, of deprescription of those therapies no longer essential.