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Failure to adhere to recommended medication regimens is a real problem that has negative consequences for patients, providers, health plans, employers, industry, and society. The national dialogue on health reform that is currently under way includes a discussion of ways to improve care for persons with chronic disease and to improve the value and efficiency of health care. Strategies to improve adherence to medication therapy fall squarely in these discussions, since nonadherence affects the ability to effectively manage and control chronic diseases and contributes to the costs society incurs. This literature review was requested as background for a conference focusing on policy options to improve medication adherence. It identifies barriers to medication adherence with a strong evidence base and discusses key lessons from the literature that are relevant for the policy discussion.

Table of Contents

  • Chapter One


  • Chapter Two

    Conceptual Framework

  • Chapter Three

    Systematic Review of Non-Cost-Related Barriers to Medication Adherence

  • Chapter Four

    Previous Reviews of Medication Adherence

  • Chapter Five


  • Chapter Six

    Framework for Discussing Policy Options

  • Appendix A

    Measurement of Medication Adherence.

  • Appendix B

    Evidence Table for Systematic Review of Non-Cost-Related Barriers to Medication Adherence

The research in this report was sponsored by Mehlman Vogel Castagnetti, Inc. and conducted by RAND Health.

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