Abstract
Adherence to therapy is a primary determinant of treatment success. Poor adherence atenuates optimum clinical benefits and therefore reduces the overal effectivness of health systems.
According to the World Health Organization, risk factors/predictors for nonadherence may be categorized based on five interacting dimensions: socioeconomic, health-care system-related, disease-related, therapy-related, and patient-related. Nonadherence to pharmacotherapy may include non-acceptance of drug prescription start, poor execution of the drug regimen, discontinuation and the drug prescription end.
Databases on adherence to pharmacotherapy in rheumatic diseases include a large amount of prospective and retrospective studies with variable methods of investigation, i.e. from questionaries and detection the presence of drugs or metabolites in biologic fluids up to sophisticated electronic telemetry. A data are suggestive that nonadherence to pharmacotherapy should be a risk factor even to fatal prognosis, incl. nonadherence in relation to placebo.
In this connection a characteristics of nonadherence syndrome were declared. In rheumatic diseases were analysed especially data as follows: disease modyfying anti-rheumatic drug therapy in rheumatoid arthritis, glucocorticoids in polymyalgia rheumatica, hydroxychloroquine and immunosuppressive therapy in systemic lupus erythematosus and uric acid blockers in gout.
A good information on poor adherence to pharmacotherapy of rheumatic diseases suppose successful education of patients in the whole clinical practice.