Table 1.

Barriers Associated With Medication Adherence

Patient-related barriers

Forgetfulness Symptom self-management Schedule disruptions, vacations, holidays Inadequate or incomplete instructions Lack of knowledge or poor understanding about the condition and medication used to treat it Cultural, health, and/or religious beliefs about the medication Denial or ambivalence regarding conditions Financial challenges Lack of health literacy Lack of social support Lack of transportation to appointments and/or pharmacy Confusion about prescription labels Difficulty swallowing medication (e.g., dysphagia) Depression and other mental health conditions Chaotic lifestyle

Medication-related barriers

Number of pills Frequency of dosing Side effects or adverse effects from the medication Taking multiple medications at the same time Length of therapy Pharmacy wait time Size and taste of pill Dosing instructions (e.g., in relation to meals)

Clinician-related barriers

Lack of trust in clinician Poor communication with clinician Providers’ being pressed for time during office visits Cultural, health, and/or religious beliefs—disparity between clinician and patient Lack of time and skill to address complex behavior of poor adherence

Health system barriers

Lack of or inadequate health insurance and drug coverage Difficulty making appointments, barriers to accessing initial prescriptions or refills Lack of feedback and ongoing communication Lack of reliable, valid tools to provide information on adherence at the point of care