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Section II
Improving adherence rates:
guidance for countries
S E C T I O N   I I
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Chapter IV
C H A P T E R   I V
Lessons learned
1.Patients need to be supported,not blamed
2.The consequences of poor adherence to long-term therapies are 
poor health outcomes and increased health care costs
3.Improving adherence also enhances patient safety
4.Adherence is an important modifier of health system effectiveness
5.Improving adherence might be the best investment for tackling 
chronic conditions effectively
6.Health systems must evolve to meet new challenges
7.A multidisciplinary approach towards adherence is needed
Over the past 40 years,health,behavioural and social scientists have been accumulating knowledge
concerning the prevalence of poor adherence,its determinants and interventions.This report is an
attempt to integrate diverse findings across a number of diseases in order to stimulate intersectoral
awareness of the magnitude and impact of poor adherence to therapies for chronic conditions,to catal-
yse discussion,and to identify specific targets for further research and intervention.
Several key lessons have emerged or have been reinforced by evidence from the reviews discussed in
this report.These are described below.
1.Patients need to be supported,not blamed
Despite evidence to the contrary,there continues to be a tendency to focus on patient-related factors
as the causes of problems with adherence,to the relative neglect of provider and health system-related
determinants.These latter factors make up the health care environment in which patients receive care
and have a considerable effect on adherence.Interventions that target the relevant factors in the health
care environment are urgently required.
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