DETERMINANTS OF MEDICATION ADHERENCE IN PATIENTS WITH CARDIOVASCULAR DISEASES: A SYSTEMATIC REVIEW

Abstract

Introduction: Adherence to treatment of chronic cardiovascular diseases is a multifaceted challenge that involves factors related to the patient, treatment, socioeconomic conditions, and the health system. Non-adherence to treatment contributes to the worsening of clinical outcomes and increases the burden of cardiovascular diseases in the population. Objective: This study seeks to identify and understand the factors that influence adherence to drug treatment of chronic cardiovascular diseases, from the perspective of both the physician and the patient, with the aim of developing effective interventions that promote treatment continuity and reduce complications associated with CVD. Methodology: A systematic review was carried out using PubMed databases. The searches included the descriptors combined with the Boolean term "AND": Cardiovascular Diseases, Medication Adherence, Barriers, Facilitators. A total of 315 articles were found, of which 45 were selected after applying the inclusion and exclusion criteria. Of these, 12 studies were used to compose the collection of the discussion. Results: The results highlight that non-adherence to treatment is influenced by a combination of factors, including lack of understanding of the disease, forgetfulness, lack of family support, concerns about side effects, and issues related to the health system. The doctor-patient relationship is crucial in promoting adherence, with effective communication and shared decision-making playing essential roles. The patient's perception of the severity of the disease and the consequences of non-adherence are also important determinants. Conclusion: Integrated approaches, which include continuous patient education, simplification of treatment regimens, financial support, and facilitated access to health services, are key to improving treatment adherence. Understanding the causes and motivations of non-adherence allows the development of effective interventions that promote continuity of treatment and improve clinical outcomes, significantly reducing complications associated with cardiovascular diseases.