Adherence
Claudia Schneider studied philosophy, theater, film and media studies and media theory in Innsbruck, Vienna and Linz. A great interest in the body, how it stays healthy and what makes it sick, has accompanied her since childhood. She has been supporting the editorial team with enthusiasm since 2020 and enjoys spending her free time with lots of exercise and a good book.
More about the experts All content is checked by medical journalists.In medicine, adherence describes the so-called adherence to therapy. It is based on a treatment plan that both the patient and the doctor have drawn up together. As a result, both sides make a significant contribution to adherence. Above all, this plays a decisive role in the treatment of chronic diseases. Read more about adherence and why it is important here!
What does adherence mean?
The term adherence defines how well both patient and doctor adhere to a jointly developed treatment plan. One also speaks of “therapy adherence”. Since the active part is largely in the hands of the patient, terms such as patient adherence have also become established.
The term compliance was particularly widespread in the past. Like adherence, it generally stands for adherence to therapy. However, experts see the term as too one-sided. Compliance is therefore limited to the patient simply following the therapy prescribed by the doctor.
Adherence starts earlier here, namely when a treatment concept is agreed: the patient does not simply submit to a treatment imposed by the doctor, but also helps to determine it himself. Both sides then stick to the defined therapy plan as best as possible in order to actually achieve the treatment goal.
What does the patient do?
After the patient and his team of doctors have discussed a treatment, it is largely up to the patient to adhere to the agreed therapeutic measures and goals. On the part of the sick person, this includes, for example:
- correct intake of medication
- Compliance with certain requirements of the doctor (e.g. temporary bed rest)
- Change of diet
- Avoiding addictive substances such as alcohol and cigarettes
- Change in movement behavior
Ultimately, patient adherence is measured by how successfully the person concerned copes with his or her part.
How does the doctor contribute to adherence?
For a successful treatment, it is important that the doctor thoroughly informs the patient in advance about each individual therapy step and removes any uncertainties. He also makes sure that the patient can actually implement the treatment. For this purpose, the doctor takes into account, for example, the severity of the disease as well as the age and general condition of the patient. He also has to keep an eye on the patient's everyday and social environment.
If the patient is plagued by worries and fears during therapy, the doctor will take care of them. In addition, he supports and motivates when necessary. It is also important that the doctor and patient meet regularly. This is used to monitor treatment and identify problems early on. This enables both sides to make any necessary adjustments in good time.
If, on the other hand, the treatment is stopped or not used as planned, experts speak of non-adherence.
What influences the adherence?
The extent to which patients adhere to measures over a longer period of time depends on several factors. Patients who suffer from asymptomatic or asymptomatic disease generally show less adherence to therapy. On the other hand, patients who suffer from several or particularly severe complaints at the same time are more adherent to therapy.
In addition, how tolerable and complex a treatment is has an impact on therapy compliance. If drugs cause few or no side effects and if further treatment measures can be easily integrated into the patient's everyday life, this increases adherence.
In general, the following applies: Patients who clearly feel the treatment success are motivated by the increased quality of life to continue their therapy. The tendency to break off in the first year of treatment is particularly high.
These factors are important for adherence
The different factors that influence adherence to therapy can be divided into:
Indication-related factors:
These include the course of the disease, severity of the disease, psychological and social consequences, availability of therapy and its duration. If the suffering is great, the therapy easily available and easy to implement, this promotes the patient's adherence.
Therapy-related factors:
This includes side effects, the complexity of a therapy and how the treatment affects the quality of life. If the patient tolerates his medication well and also experiences an improvement, the increased quality of life motivates him to continue the treatment. However, if the therapy requires the intake of many different preparations and severe side effects occur, this makes therapy compliance more difficult.
Health system relevant factors:
Reimbursement of costs, training of medical staff, availability of medical care (e.g. doctor or physiotherapy practices) and the doctor-patient relationship also influence adherence. Support from the health insurance company and the availability and accessibility of the attending physician, for example, promote the success of the therapy.
Individual and socio-economic factors:
This includes, among other things, the general attitude and expectations of the patient, but also the doctor's motivation. A positive attitude and honest dealings with one another are prerequisites for achieving the treatment goals discussed. In the case of older patients and children, their social environment, such as their children or parents, is also decisive.
Why is adherence important?
Adherence is especially important when a disease requires long-term therapy. This is particularly the case with chronic diseases such as asthma, high blood pressure or diabetes. Individual measures and medications often take some time to work. You therefore need a special degree of adherence to therapy so that the improvement occurs.
In general, it is important to measure the success of treatment realistically. Here it is primarily up to the doctor to inform the person concerned about goals that can really be achieved. Success is not always to be equated with a complete cure, especially not in the case of chronic diseases. Rather, the improvement of the symptoms is a sign of a well-coordinated therapy.
But even then, adherence is still crucial. If the person concerned stops taking antihypertensive drugs because they are measuring good values, their blood pressure will most likely return to an unhealthy level. The aim of the treatment is not only to lower the blood pressure values, but also to remain true to the therapy even after an improvement. Nonetheless, this adherence means that doctor and patient exchange ideas and adjust the medication if necessary.
Do not stop taking medication on your own without consulting your doctor!
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