ABSTRACT
In affluent countries, the biggest slice of the health care pie is consumed by the management of chronic diseases such as coronary heart disease, diabetes and asthma. Here, good outcomes depend as much on self-management as on good medical care and, for most of these conditions, self-management hinges on the appropriate use of medicines. But it is thought that over a third of prescribed medicines are not taken as directed (Horne, 1997). Nonadherence is a concern for those providing, receiving or funding care because it not only entails a waste of resources but also a missed opportunity for therapeutic benefit. However, few effective interventions to facilitate adherence have been developed (Haynes et al., 1996) and there is increasing interest in understanding why so many patients do not adhere to treatment and in finding ways of helping patients get the most from prescribed medication.
