Skip to main content

Advertisement

Log in

The impact of medication regimen factors on adherence to chronic treatment: a review of literature

  • Published:
Journal of Behavioral Medicine Aims and scope Submit manuscript

Abstract

This article reviews recent literature in chronic illness or long-term health management including asthma, contraception, diabetes, HIV disease, and hypertension/cardiovascular disease, mental disorders, pain, and other diseases to determine the relationship between regimen factors and adherence to medications. The authors conducted an electronic literature search to detect articles published between 1998 and 2007. Articles were included if they pertained to a chronic illness or to contraception, included a clear definition of how adherence was measured, and included regimen factors as primary or secondary explanatory variables. Methodology of the studies varied greatly, as did methods of measuring adherence and regimen factors. Surprisingly few of these articles concerned (1) chronic treatment, (2) regimen factors such as dosing, pill burden, and regimen complexity, and (3) adherence measured in a clear manner. Most studies failed to use state-of-the-art methods of measuring adherence. Despite these flaws, a suggestive pattern of the importance of regimen factors, specifically dose frequency and regimen complexity, emerged from this review.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  • Amico, K. R., Harman, J. J., & Johnson, B. T. (2006). Efficacy of antiretroviral therapy adherence interventions: A research synthesis of trials, 1996 to 2004. Journal of Acquired Immune Deficiency Syndrome, 41(3), 285–297.

    Article  Google Scholar 

  • Ammassari, A. A., Starace, F., Aloisi, M. S., Trotta, M. P., Murri, R., D’Arminio Monforte, A., & Antinori, A. (2003). Medication adherence among HIV+ adults: Effects of cognitive dysfunction and regimen complexity. Neurology, 61, 723–724.

    PubMed  Google Scholar 

  • Balint, S., & O’Donnell, R. (2007). Beyond compliance. Occupational Health & Safety (Waco, Tex.), 76(6), 104, 106–107.

    Google Scholar 

  • Bedell, S. E., Jabbout, S., Goldberg, R., Glaser, H., Gobble, S., & Young-Xu, Y., et al. (2000). Discrepancies in the use of medications: Their extent and predictors in an outpatient practice. Archives of Internal Medicine, 160, 2129–2134.

    Article  PubMed  Google Scholar 

  • Burke, W. J., & McArthur-Miller, D. A. (2001). Exploring treatment alternatives: Weekly dosing of fluoxetine for the continuation phase of major depressive disorder. Journal of Clinical Psychiatry, 62(Suppl), 38–42.

    PubMed  Google Scholar 

  • Burkman, R. T. (2002). The transdermal contraceptive patch: A new approach to hormonal contraception. International Journal of Fertility Womens’ Medicine, 47, 69–76.

    Google Scholar 

  • Chapman, R. H., Benner, J. S., Petrilla, A. A., Tierce, J. C., Collins, S. R., Battleman, D. S., et al. (2005). Predictors of adherence with antihypertensive and lipid-lowering therapy. Archives of Internal Medicine, 165, 1147–1152.

    Article  PubMed  Google Scholar 

  • Chengappa, K. N., Parepally, H., Brar, J. S., Mullen, J., Shilling, A., & Goldstein, J. M. (2003). A random-assignment, double-blind, clinical trial of once- vs twice-daily administration of quetiapine fumarate in patients with schizophrenia or schizoaffective disorder: A pilot study. Canadian Journal of Psychiatry, 48, 187–194.

    Google Scholar 

  • Claxton, A. J., Cramer, J., & Pierce, C. (2001). A systematic review of the associations between dose regimens and medication compliance. Clinical Therapy, 23, 1296–1310.

    Article  Google Scholar 

  • Dezii, C. M., Kawabata, H., & Tran, M. (2002). Effects of once-daily and twice-daily dosing on adherence with prescribed glipizide oral therapy for type 2 diabetes. Southern Medical Journal, 95, 68–71.

    PubMed  Google Scholar 

  • Dieben, T. O., Roumen, F. J., & Apter, D. (2002). Efficacy, cycle control, and user acceptability of a novel combined contraceptive vaginal ring. Obstetrics and Gynecology, 100, 585–593.

    Article  PubMed  Google Scholar 

  • Dittrich, R., Parker, L., Rosen, J. B., Shangold, G., Creasy, G. W., Fisher, A. C., & Ortho Evra/Evra 001 Study Group (2002). Transdermal contraception: Evaluation of three transdermal norelgestromin/ethinyl estradiol doses in a randomized, multicenter, dose-response study. American Journal of Obstetrics and Gynecology, 186, 15–20.

    Google Scholar 

  • Dolce, J. J., Crisp, C., Manzella, B., Richards, J. M., Hardin, J. M., & Bailey, W. C. (1991). Medication adherence patterns in chronic obstructive pulmonary disease. Chest, 99, 837–841.

    Article  PubMed  Google Scholar 

  • Donnan, P. T., MacDonald, T. M., & Morris, A. D. (1996). Adherence to prescribed oral hypoglycaemic medication in a population of patients with type 2 diabetes: A retrospective cohort study. Diabetic Medicine, 19, 270–284.

    Google Scholar 

  • Dunbar-Jacob J., Bohachick P., Mortimer M. K., Sereika S. M., & Foley S. M. (2003). Medication adherence in persons with cardiovascular disease. Journal of Cardiovascular Nursing, 18, 209–218.

    PubMed  Google Scholar 

  • Eisen, S. A., Miller, D. K., & Woodward, R. S. (1990). The effect of prescribed daily dose frequency on patient medication compliance. Archives of Internal Medicine, 150, 1881–1884.

    Article  PubMed  Google Scholar 

  • Eldred, L. J., Wu, A. W., Chaisson, R. E., & Moore, R. D. (1998). Adherence to antiretroviral and Pneumocystis prophylaxis in HIV disease. Journal of Acquired Immune Deficiency Syndrome, 18, 117–125.

    Google Scholar 

  • Eron, J. J., Yetzer, E. S., Ruane, P. J., et al. (2000). Efficacy, safety, and adherence with a twice daily combination lamivudine/zidovudine tablet formulation, plus a protease inhibitor, in HIV infection. AIDS, 14, 671–681.

    Article  PubMed  Google Scholar 

  • Ferguson, T. F., Stewart, K. E., Funkhouser, E., Tolson, J., Westfall, A. O., & Saag, M. S. (2002). Patient-perceived barriers to antiretroviral adherence: Associations with race. AIDS Care, 14, 607–617.

    Article  PubMed  Google Scholar 

  • Flandre, P., Peytavin, G., Meiffredy, V., Saidi, Y., Descomps, D., Delagnes, M., Brun-Vezinet, F., & Roffi, F. (2002). Adherence to antiretroviral therapy and outcomes in HIV-infected patients enrolled in an induction/maintenance randomized trial. Antiviral Therapy, 7, 113–121.

    PubMed  Google Scholar 

  • Fogarty, L., Roter, D., Larson, S., Burke, J., Gillespie, J., & Levy, R. (2002). Patient adherence to HIV medication regimens: A review of published and abstract reports. Patient Education and Counseling, 46, 93–108.

    Article  PubMed  Google Scholar 

  • Gallo, M. F., Grimes, D. A., & Schulz, K. F. (2003). Skin patch and vaginal ring versus combined oral contraceptives for contraception. Cochrane Database of Systematic Reviews, 1, CD003552.

  • George, J., Phun, Y. T., Bailey, M. J., Kong, D. C., & Stewart, K. (2004). Development and validation of the medication regimen complexity index. The Annals of Pharmacotherapy, 38, 1369–1376.

    Article  PubMed  Google Scholar 

  • George, J., & Shalansky, S. J. (2007). Predictors of refill non-adherence in patients with heart failure. British Journal of Clinical Pharmacology, 63, 488–493.

    Article  PubMed  Google Scholar 

  • Gerald, L. B., McClure, L. A., Harrington, K. F., Mangan, J. M., Gibson, L., Atchison, J., et al. (2007). Design of the supervised asthma therapy study: Implementing an adherence intervention in urban elementary schools. Contemporary Clinical Trials, in press.

  • Golden, R. N., Nemeroff, C. B., McSorley, P., et al. (2002). Efficacy and tolerability of controlled-release and immediate release paroxetine in the treatment of depression. Journal of Clinical Psychiatry, 63, 577–584.

    PubMed  Google Scholar 

  • Golin, C. E., Liu, H., Hays, R. D., Miller, L. G., Beck, C. K., Ickovics, J., Kaplan, A. H., & Wenger, N. S. (2002). A prospective study of predictors of adherence to combination antiretroviral medication. Journal of General Internal Medicine, 17, 756–765.

    Article  PubMed  Google Scholar 

  • Grant, R. W., Devita, N. G, Singer, D. E., & Meigs, J. B. (2003). Polypharmacy and medication adherence in patients with type 2 diabetes. Diabetes Care, 26, 1408–1412.

    Article  PubMed  Google Scholar 

  • Halkitis, P. N., Parsons, J. T., Wolitski, R. J., & Remien, R. H. (2003). Characteristics of HIV antiretroviral treatments, access and adherence in an ethnically diverse sample of men who have sex with men. AIDS Care, 15, 89–102.

    Article  PubMed  Google Scholar 

  • Hanchak, N. A., Patel, M. B., Berlin, J. A., & Strom, B. L. (1996). Patient misunderstanding of dosing instructions. Journal General Internal Medicine, 11, 325–328.

    Article  Google Scholar 

  • Hays, H., Hagen, N., Thirlwell, M., Dhaliwal, H., Babul, N., Harsanyi, Z., & Darke, A. C. (1994). Comparative clinical efficacy and safety of immediate release and controlled release hydromorphone for chronic severe cancer pain. Cancer, 74, 1808–1816.

    Article  PubMed  Google Scholar 

  • Haynes, R. B., McDonald, H. P., & Garg, A. X. (2002). Helping patients follow prescribed treatment: Clinical applications. Journal of the American Medical Association, 288, 2880–2883.

    Article  PubMed  Google Scholar 

  • Hinkin, C. H., Castellon, S. A., Durvasula, R. S., Hardy, D. J., Lam, M. N., Mason, K. I., Thrasher, D., Goetz, M. B., & Stefaniak, M. (2002). Medication adherence among HIV+ adults: Effects of cognitive dysfunction and regimen complexity. Neurology, 59, 1944–1950.

  • Ickovics, J. R., & Meisler, A. W. (1997). Adherence in AIDS clinical trials: A framework for clinical research and clinical care. Journal of Clinical Epidemiology, 50, 385–391.

    Article  PubMed  Google Scholar 

  • Iskedjian, M., Einarson, T. R., MacKeigan, L. D., Shear, N., Addis, A., Mittmann, N., & Ilersich, A. L. (2002). Relationship between daily dose frequency and adherence to antihypertensive pharmacotherapy: Evidence from a meta-analysis. Clinical Therapy, 24, 302–316.

    Article  Google Scholar 

  • Kane, S. V. (2006). Systematic review: Adherence issues in the treatment of ulcerative colitis. Alimentary Pharmacology and Therapeutics, 23, 577–585.

    Article  PubMed  Google Scholar 

  • Kardas, P. (2005). The DIACOM study (effect of Dosing frequency of oral Antidiabetic agents on the COMpliance and biochemical control of type 2 diabetes). Diabetes, Obesity and Metabolism, 7, 722–728.

    Article  PubMed  Google Scholar 

  • Katlama, C., Clumeck, N., Fenske, S., et al. (2001). Use of trizivir to simplify therapy in HAART-experienced patients with long-term suppression of HIV-RNA: TRIZIAL study (AZL 30002) 24-week results. Presented at the 8th Conference on Retroviruses and Opportunistic Infections, Chicago, Feb. 4–8, 2001, Abstract 316.

  • Kelloway, J. S., Wyatt, R. A., & Adlis, S. A. (1994). Comparison of patients’ compliance with prescribed oral and inhaled asthma medications. Archieves of Intern Medicine, 154, 1349–1352.

    Article  Google Scholar 

  • Kubacka, R. T., & Juhl, R. P. (1985). Attitudes of patients with hypertension or arthritis toward the frequency of medication administration. American Journal of Hospital Pharmacy, 42, 2499–2501.

    PubMed  Google Scholar 

  • Lee, J. Y., Kusek, J. W., Greene, P. G., Bernhard, S., Norris, K., Smith, D., Wilkening, B., & Wright, J. T. Jr. (1996). Assessing medication adherence by pill count and electronic monitoring in the African American Study of Kidney Disease and Hypertension (AASK) Pilot Study. American Journal of Hypertension, 9, 719–725.

    Article  PubMed  Google Scholar 

  • Lee, M., Kemp, J. A., Canning, A., Egan, C., Tataronis, G., & Farraye, F. A. (1999). A randomized controlled trial of an enhanced patient compliance program for Helicobacter pylori therapy. Archives of Internal Medicine, 159, 2312–2316.

    Article  PubMed  Google Scholar 

  • Mai, L., & Eng, J. (2007). Community-based elder care: A model for working with the marginally housed elderly. Care Management Journals, 8(2), 96–99.

    Article  PubMed  Google Scholar 

  • Mann, E., Eliasson, O., Patel, K., & ZuWallack, R. L. (1992). A comparison of the effects on bid and qid dosing on compliance with inhaled flunisolide. Chest, 101, 496–499.

    Article  PubMed  Google Scholar 

  • Martin, S., Wolters, P. L., Calabrese, S. K., Toledo-Tamula, M. A., Wood, L. V., Roby, G., et al. (2007). The Antiretroviral Regimen Complexity Index: A novel method of quantifying regimen complexity. Journal of Acquired Immune Deficiency Syndrome, 45, 1–10.

    Article  Google Scholar 

  • Masand, P. S. (2003). Tolerability and adherence issues in antidepressant therapy. Clinical Therapy, 25, 2289–2304.

    Article  Google Scholar 

  • McDonald, H. P., Garg, A. X., & Haynes, R. B. (2002). Interventions to enhance patient adherence to medication prescriptions: Scientific review. Journal of the American Medical Association, 288, 2868–2879.

    Article  PubMed  Google Scholar 

  • McNabb, J. J., Nicolau, D. P., Stoner, J. A., & Ross, J. (2003). Patterns of adherence to antiretroviral medications: The value of electronic monitoring. AIDS, 17, 1763–1767.

    Article  PubMed  Google Scholar 

  • Misra, A., & Ganda, O. P. (2007). Migration and its impact on adiposity and type 2 diabetes. Nutrition (Burbank, Los Angeles County, Calif.), 23(9), 696–708.

    Google Scholar 

  • Molassiotis, A., Lopez-Nahas, V., Chung, W. Y., & Lam, S. W. (2003). A pilot study of the effects of a behavioural intervention on treatment adherence in HIV-infected patients. AIDS Care, 15, 125–135.

    Article  PubMed  Google Scholar 

  • Morley, J. S., Bridson, J., Nash, T. P., Miles, J. B., White, S., & Makin, M. K. (2003). Low-dose methadone has an analgesic effect in neuropathic pain: A double-blind randomized controlled crossover trial. Palliative Medicine, 17, 576–587.

    Article  PubMed  Google Scholar 

  • Murphy, D. A., Roberts, K. J., Martin, D. J., Marelich, W., & Hoffman, D. (2000). Barriers to antiretroviral adherence among HIV-infected adults. AIDS Patient Care and STDs, 14, 47–58.

    Article  PubMed  Google Scholar 

  • O’Shea, S. D., Taylor, N. F., & Paratz, J. D. (2007). But watch out for the weather: Factors affecting adherence to progressive resistance exercise for persons with COPD. Journal of Cardiopulmonary Rehabilitation and Prevention, 27(3), 166–174; quiz 175–176.

    PubMed  Google Scholar 

  • Paes, A. H., Bakker, A., & Soe-Agnie, C. J. (1997). Impact of dosage frequency on patient compliance. Diabetes Care, 20, 1512–1517.

    Article  PubMed  Google Scholar 

  • Paterson, D. L., Swindells, S., Mohr, J., Brester, M., Vergis, E. N., Squier, C., Wagener, M. M., & Singh, N. (2000). Adherence to protease inhibitor therapy and outcomes in patients with HIV infection. Annals of Internal Medicine, 133, 21–30.

    PubMed  Google Scholar 

  • Peterson, A. M., Takiya, L., & Finley, R. (2003). Meta-analysis of trials of interventions to improve medication adherence. American Journal of Health System Pharmacy, 60, 657–665.

    PubMed  Google Scholar 

  • Pinter, B. (2002). Continuation and compliance of contraceptive use. European Journal of Contraception and Reproductive Health Care, 7, 178–183.

    Article  PubMed  Google Scholar 

  • Portsmouth, S. D., Osorio, J., McCormick, K., Gazzard, B. G., & Moyle, G. J. (2005). Better maintained adherence on switching from twice-daily to once-daily therapy for HIV: A 24-week randomized trial of treatment simplification using prolonged-release capsules. HIV Medicine, 6, 185–190.

    Article  PubMed  Google Scholar 

  • Purucker, M. E., Rosebraugh, C. J., Zhou, F., & Meyer, R. J. (2003). Inhaled fluticasone propionate by diskus in the treatment of asthma: A comparison of the efficacy of the same nominal dose given either once or twice a day. Chest, 124, 1584–1593.

    Article  PubMed  Google Scholar 

  • Richter, A., Anton, S. E., Koch, P., & Dennett, S. L. (2003). The impact of reducing dose frequency on health outcomes. Clinical Therapy, 25, 2307–2335.

    Article  Google Scholar 

  • Rueda, S., Park-Wyllie, L. Y., Bayoumi, A. M., Tynan, A. M., Antoniou, T. A., Rourke, S. B., & Glazier, R. H. (2006). Patient support and education for promoting adherence to highly active antiretroviral therapy for HIV/AIDS. Cochrane Database Systematic Review, 3, CD001442.

  • Sankar, A. P., Nevedal, D. C., Neufeld, S., & Luborsky, M. R. (2007). What is a missed dose? Implications for construct validity and patient adherence. AIDS Care, 19(6), 775–780.

    Article  PubMed  Google Scholar 

  • Shoptaw, S., Reback, C. J., & Freese, T. E. (2002). Patient characteristics, HIV serostatus, and risk behaviors among gay and bisexual males seeking treatment for methamphetamine abuse and dependence in Los Angeles. Journal of Addictive Diseases, 21, 91–105.

    Article  PubMed  Google Scholar 

  • Sicat, B. L. (2003). Ortho Evra, a new contraceptive patch. Pharmacotherapy, 23, 472–480.

    Article  PubMed  Google Scholar 

  • Simoni, J. M., Pearson, C. R., Pantalone, D. W., Marks, G., & Crepaz, N. (2006). Efficacy of interventions in improving highly active antiretroviral therapy adherence and HIV-1 RNA viral load. Journal of Acquired Immune Deficiency Syndrome, 43, S1, S23–S35.

  • Stone, V. E., Hogan, J. W., Schuman, P., Rompalo, A. M., Howard, A. A., Korkontzelou, C., & Smith, D. K. (2001). Antiretroviral regimen complexity, self-reported adherence, and HIV patients’ understanding of their regimens: Survey of women in the HER study. Journal of Acquired Immune Deficiency Syndromes, 28, 124–131.

    Google Scholar 

  • Trotta, M. P., Ammassari, A., Melzi, S., Zaccarelli, M., Ladisa, N., Sighinolfi, L., Mura, M. S., d’Arminio Monforte, A., Antinori, A., & AdICoNA Study Group (2002). Treatment-related factors and highly active antiretroviral therapy adherence. Journal of Acquired Immune Deficiency Syndromes, 31(Suppl 3), S128–131.

    Google Scholar 

  • Wilson, I. B., Tchetgen, E., & Spiegelman, D. (2001). Patterns of adherence with antiretroviral medications: An examination of between-medication differences. Journal of Acquired Immune Deficiency Syndromes, 28, 259–263.

    PubMed  Google Scholar 

  • Witteveen, E., & van Ameijden, E. J. (2002). Drug users and HIV-combination therapy (HAART): Factors which impede or facilitate adherence. Substance Use and Misuse, 37, 1905–1925.

    Article  PubMed  Google Scholar 

  • Wohl, D. A., Stephenson, B. L., Golin, C. E., Kiziah, C. N., Rosen, D., Ngo B., Liu, H., & Kaplan, A. H. (2003). Adherence to directly observed antiretroviral therapy among human immunodeficiency virus-infected prison inmates. Clinical Infectious Diseases, 36, 1572–1576.

    Article  PubMed  Google Scholar 

  • World Health Organization (WHO). (2003). Adherence to long-term therapies: Evidence for action. Geneva, Switzerland: WHO.

    Google Scholar 

  • Yiannakopoulou, E. C., Papadopulos, J. S., Cokkinos, D. V., & Mountokalakis, T. D. (2005). Adherence to antihypertensive treatment: A critical factor for blood pressure control. European Journal of Cardiovascular Prevention and Rehabilitation, 12, 243–249.

    Article  PubMed  Google Scholar 

Download references

Acknowledgments

This article was prepared with the support of NIMH K01 MH01688 and NIDA R01 DA 016554. We wish to thank Leah Farrell, M.S., for research assistance.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Karen S. Ingersoll.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Ingersoll, K.S., Cohen, J. The impact of medication regimen factors on adherence to chronic treatment: a review of literature. J Behav Med 31, 213–224 (2008). https://doi.org/10.1007/s10865-007-9147-y

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10865-007-9147-y

Keywords

Navigation