Defining, measuring, and addressing medication non-adherence in cardiovascular disease

Cardiovascular medications that can increase life expectancy, reduce hospitalizations, and improve quality of life are more available than ever. Therefore, we are faced with a new challenge: we know which therapies we should be using, but how do we enable and empower people to use them? This question centers around the concept of therapy adherence, which is defined as “the extent to which a person’s behavior – taking medication, following a diet, and/or executing lifestyle changes – corresponds with agreed recommendations from a health care provider”. Adherence is a complex, multi-factorial collection of behaviors and environmental factors that contribute to how an individual engages with their prescribed therapy. Accordingly, estimates of the burden of non-adherence, and descriptions of its antecedent causes vary widely in the literature. Given the chronic nature of cardiovascular disease, international guidelines contain recommendations to monitor and improve long-term adherence to sustain the clinical benefits of medications.