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Barriers to treatment: describing them from a different perspective

Authors Devine F, Edwards T, Feldman SR

Received 27 July 2017

Accepted for publication 11 December 2017

Published 17 January 2018 Volume 2018:12 Pages 129—133

DOI https://doi.org/10.2147/PPA.S147420

Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Dr Colin Mak

Peer reviewer comments 2

Editor who approved publication: Dr Johnny Chen


Francesca Devine,1 Taylor Edwards,1 Steven R Feldman1–3

1Center for Dermatology Research, Department of Dermatology, 2Department of Pathology, 3Department of Social Sciences & Health Policy, Wake Forest School of Medicine, Winston-Salem, NC, USA

Background: Poor adherence is the result of many barriers. Most of the adherence research has focused on the patients’ hurdles to adherence, instead of the responsibility the physician has for assuring adherence to treatment.
Objective: The purpose of this review is to identify barriers to medication adherence and refocus how we describe those barriers in terms of physician behavior hurdles.
Methods: PubMed was systematically searched for systematic reviews published between January 01, 2010, and December 06, 2017, that provided barriers to medication adherence. The searches were limited to reviews having adherence to medication prescribed in the outpatient setting as the main topic.
Results: Thirty-one reviews were included in this review, covering 13 different disease categories. Fifty-eight different barriers to adherence to medications for chronic conditions were identified. Nineteen barriers were cited 6 or more times, and these were further categorized based on the World Health Organization’s 5 dimensions of adherence and the number of times cited.
Conclusion: This review provides clear evidence that adherence to medication is affected by multiple barriers. To facilitate this, adherence barriers can be framed as physician/health system hurdles. With that focus in mind, we may put the responsibility where we have the most control.

Keywords: medication adherence, patient compliance, medication non-compliance, patient acceptance of health care

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