Problems of nonadherence in cardiology and proposals to improve outcomes

Am J Cardiol. 2010 May 15;105(10):1495-501. doi: 10.1016/j.amjcard.2009.12.077.


At least 1 in 7 cardiology patients now reports nonadherence to prescribed medications, potentially leading to negative outcomes across a broad range of cardiovascular diseases. This nonadherence can begin as early as the time of prescription or any time thereafter and occurs for a variety of reasons, including communication difficulties, polypharmacy, and a variety of objective and perceived side-effects. Among elderly, low-income, and disabled patients, drug costs represent a growing source of medication nonadherence and can be markedly reduced through the use of drug assistance programs and low-cost generic medications without sacrificing evidence-based therapy. Depression also contributes strongly to nonadherence and is widely prevalent in cardiovascular populations. Improvements in depression are mirrored by improvements in adherence. A systematic screening to identify the presence of nonadherence and many of its causes can be accomplished with minimal impact on visit length. In conclusion, once specific concerns are recognized, options frequently exist to help patients and providers address many of the most common difficulties.

Publication types

  • Review

MeSH terms

  • Age Factors
  • Cardiovascular Agents / administration & dosage*
  • Cardiovascular Agents / economics
  • Cardiovascular Diseases / diagnosis
  • Cardiovascular Diseases / drug therapy*
  • Depressive Disorder / diagnosis
  • Depressive Disorder / epidemiology
  • Drug Prescriptions*
  • Evidence-Based Medicine
  • Female
  • Humans
  • Male
  • Needs Assessment
  • Patient Compliance / statistics & numerical data*
  • Patient Education as Topic*
  • Risk Assessment
  • Socioeconomic Factors
  • United States


  • Cardiovascular Agents