The role of patient preferences in adherence to treatment in chronic disease: a narrative review

Abstract

Adherence to prescribed medication is important to the management of all diseases, especially those of chronic nature. Drug effectiveness is substantially compromised by therapy nonadherence. We reviewed the available evidences on the impact of patient preferences for therapy on adherence to a prescribed treatment in chronic diseases requiring long-term treatment. A search on PubMed retrieved 699 publications, leading to a selection of 12 publications: 6 on osteoporosis, 2 on moderate-to-severe asthma, 1 on type 1 diabetes, 1 on type 2 diabetes, 1 on kidney transplantation, and 1 on atrial fibrillation. Overall, 8 studies found a positive association between patient preference and adherence to therapy, while the others found no association. In general, overall adherence was considered to be high in the published studies. The reasons for a positive association included reduced dosing frequency, route of administration, lower costs, and favorable safety profile, which is related to the diverse nature of the pathology and its type and duration of treatment. A literature review suggests that achieving good adherence and persistence to therapy requires evaluation of patient preferences. In a period of increasingly limited resources, more effort is warranted to promote better adherence to therapy, especially when patients must self-manage their disease in the long term. Our results further highlight that insufficient attention has been given to the relationship between patient preference and adherence and point out the complex nature of adherence and the need for adequate patient education. More efforts are also needed to better understand the entity of cost savings for payers for specific treatments and the link with patient preference.

Prevalence, causes, impacts, and management of needle phobia: An international survey of a general adult population

“…[ 10 ] Because these patients are likely suffering from chronic (e.g., kidney disease) or other severe conditions (e.g., cancer), they may be more vulnerable to needle phobia and its impacts on treatment adherence. Avoidance behavior may have a more significant impact on patients with conditions requiring frequent injections compared to healthier individuals [ 43 ]. In fact, literature reports adverse health outcomes and increased mortality in type II diabetes and hypertension patients with poor treatment adherence, which typically comprises frequent injections and blood draws [ 43 ].…”

“…Avoidance behavior may have a more significant impact on patients with conditions requiring frequent injections compared to healthier individuals [ 43 ]. In fact, literature reports adverse health outcomes and increased mortality in type II diabetes and hypertension patients with poor treatment adherence, which typically comprises frequent injections and blood draws [ 43 ].…”

Patient preferences in the treatment of chronic musculoskeletal pain: a systematic review of discrete choice experiments

“…Furthermore, an understanding of patient views and preferences is essential to enhance their participation, adherence, and satisfaction with treatment. 31 , 38 , 45 The important attributes identified by this systematic review will inform the design of future DCE and other studies aiming to determine patient preferences for various nonsurgical treatments for value-based care in patients with CMP.…”

The Quality of Life and Medication Adherence in Patients with Multiple Sclerosis—Cross-Sectional Study

“…Previous studies have shown that patients more preferably use oral pharmacotherapy [ 46 , 47 , 48 ]. Therefore, the level of adherence among patients taking oral drugs is higher than those taking injectable drugs.…”