Types of non-adherence and reasons why patients do not adhere — common mistakes

For exam questions, always clearly differentiate between intentional and unintentional non-adherence. Use specific, contrasting examples to demonstrate your understanding, such as a patient actively stopping medication due to beliefs (intentional) versus an elderly patient forgetting a dose due to memory issues (unintentional).

This is a common misconception. Non-adherence is a complex issue with multiple causes. While a patient might make a conscious choice (intentional non-adherence), this is often a 'rational' decision from their perspective, based on beliefs, side effects, or cost. Many patients are unintentionally non-adherent; they want to follow treatment but face barriers like forgetfulness, complex schedules, or lack of understanding. Blaming the patient oversimplifies the problem and ignores the roles of the healthcare provider and system.

Not at all. A key distinction in this topic is between intentional and unintentional non-adherence. Forgetting a dose is a classic example of unintentional non-adherence – there was no active decision to skip the medication. Similarly, if a patient misunderstands the instructions and takes the wrong dose, or cannot afford to refill a prescription, their non-adherence is unintentional. The patient's intent is the crucial factor in classifying the type of non-adherence.

No, adherence is a broad term that applies to any agreed recommendation from a healthcare provider. While medication adherence is the most commonly studied type, the concept also includes following dietary advice (e.g., for diabetes), attending physiotherapy appointments, undertaking prescribed exercise (e.g., for cardiac rehabilitation), or engaging in lifestyle changes like quitting smoking. The reasons for non-adherence in these areas are often similar to those for medication.