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Chapter V
C H A P T E R  V
Towards the solution
1.Five interacting dimensions affect adherence
27
2 Intervening in the five dimensions
31
3.Reference
36
1.Five interacting dimensions affect adherence
Adherence is a multidimensional phenomenon determined by the interplay of five sets of factors,here
termed “dimensions”,of which patient-related factors are just one determinant (Figure 3).The common
belief that patients are solely responsible for taking their treatment is misleading and most often
reflects a misunderstanding of how other factors affect people’s behaviour and capacity to adhere to
their treatment.
The five dimensions are briefly discussed below.The length of the discussion on each dimension
reflects the quantity of evidence available,which is biased by the traditional misconception that adher-
ence is a patient-driven problem.Therefore,the size of the section does not reflect its importance.
Figure 3
The five dimensions of adherence
Health system/
HCT–factors
Condition–related
factors
Social/economic
factors
Therapy–related
factors
Patient–related
factors
HCT,Health-care team
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