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(Circulation. 2009;119:3028-3035.)
© 2009 American Heart Association, Inc.

Key Issues in Outcomes Research

Medication Adherence

Its Importance in Cardiovascular Outcomes

P. Michael Ho, MD, PhD; Chris L. Bryson, MD, MS; John S. Rumsfeld, MD, PhD

From the Denver VA Medical Center (P.M.H., J.S.R.), Denver, Colo; University of Colorado Denver (P.M.H., J.S.R.), Denver, Color; Institute for Health Research (P.M.H., J.S.R.), Kaiser Permanente of Colorado, Aurora, Colo; Puget Sound VA Medical Center (C.L.B.), Seattle, Wash; and University of Washington (C.L.B.), Seattle, Wash.

Correspondence to P. Michael Ho, MD, PhD, 1055 Clermont St (111B), Denver, CO 80220. E-mail michael.ho{at}va.gov

Medication adherence usually refers to whether patients take their medications as prescribed (eg, twice daily), as well as whether they continue to take a prescribed medication. Medication nonadherence is a growing concern to clinicians, healthcare systems, and other stakeholders (eg, payers) because of mounting evidence that it is prevalent and associated with adverse outcomes and higher costs of care. To date, measurement of patient medication adherence and use of interventions to improve adherence are rare in routine clinical practice. The goals of the present report are to address (1) different methods of measuring adherence, (2) the prevalence of medication nonadherence, (3) the association between nonadherence and outcomes, (4) the reasons for nonadherence, and finally, (5) interventions to improve medication adherence.

Key Words: cardiovascular diseases • healthcare quality assessment • medication adherence • outcomes research