ABSTRACT
INTRODUCTION Multiple and complex factors determine medication adherence and nonadherence. Adherence to a treatment regimen indicates a patient’s observance of health care providers’ therapeutic recommendations. These therapeutic recommendations may involve the use of medications, participation in psychotherapy and completion of assigned work between sessions, and lifestyle or behavioral changes (1). Inherent within this definition of adherence is the suggestion that good patients who care about their health take medications as prescribed and bad patients who do not care about their health are nonadherent to a medication regimen. Salient research shows that nonadherence to treatment results in greater morbidity and mortality associated with chronic psychiatric illness, causing poor treatment response, increased outpatient visits and psychiatric hospitalizations, decreased social supports, increased suicides and other violent behaviors, and rising health care costs (2). In the United States, of all medication-related hospitalizations, 33-69% have been attributed to poor medication adherence. The costs (direct and indirect) of medical and psychiatric nonadherence have been estimated at $100 billion per year (3,4).
