[Durgical](https://durgical.com/en/) › [DurgiPedia](https://durgical.com/en/durgipedia/) › [Behavioral science](https://durgical.com/en/behavioral-science/) › [Health behavior and adherence](https://durgical.com/en/behavioral-science/areas/health-behavior/) › How to improve adherence

# How to improve adherence

- Technique

Adherence improves with simple regimens, a good relationship, checked education, lower costs and follow-up; no single measure is enough.

Updated Nov 5, 2026

## Key points

- Ask in a normalizing way: ‘Many people miss the odd dose; how many did you miss in the last week?’
- Simplify: fewer doses a day, combinations in one tablet, and linking the dose to a daily routine.
- Explore beliefs: the perceived need for the medicine versus concerns about its effects.
- Team-based care with pharmacists improves adherence: in a study cited by CDC, 89 % versus 74 % at 12 months.
- Lowering cost, using generics and easing supply improve adherence.
- In tuberculosis, directly observed therapy is used.

## What it is

Improving adherence means working on several dimensions at once: the patient, the therapy, the condition, the team and the social setting. Interventions that combine several strategies work better than single ones, although the effect is usually modest. The first step is to ask without judgment to find out the type of non-adherence and its cause. From there you simplify, educate, lower barriers and stay alongside the patient.

## How it is done

- Ask without judgment how many doses were missed and what makes it hard.
- Tell forgetting or confusion (unintentional) apart from a personal decision (intentional).
- Explore beliefs and fears with open questions and motivational interviewing.
- Simplify the regimen and tie the dose to fixed habits (breakfast, brushing teeth).
- Explain in plain language what each medicine is for and check with teach-back.
- Solve practical barriers: cost, transport, supply, side effects.
- Offer aids: weekly pill organizers, blister packs, calendars, alarms or reminder messages.
- Involve family or a carer if the patient agrees.
- Schedule close follow-up and acknowledge progress.

## Interventions by WHO dimension

| Dimension | Intervention |
| --- | --- |
| Social and economic | Generics, help with transport, community support networks |
| [System and team](https://durgical.com/en/conditions/hiv-infection-and-aids/) | Team-based care with pharmacists and nurses, continuity, e-prescribing, timely supply |
| [Condition](https://durgical.com/en/conditions/arterial-hypertension/) | Education about symptom-free disease, treating depression, support in cognitive impairment |
| Therapy | Fewer doses, fixed-dose combinations, active management of side effects |
| [Patient](https://durgical.com/en/conditions/arterial-hypertension/) | Motivational interviewing, teach-back, self-efficacy, reminders, self-monitoring (for example, home blood pressure) |

## Clinical notes

- According to CDC, e-prescribing increased first-fill of prescriptions, and lowering copayments slightly increased adherence.
- WHO calls for incentives and training so care teams can give behavioural support, because the problem is not the patient's alone.
- Directly observed therapy in tuberculosis is a model of the health system taking on part of the responsibility.

## Memory aid

‘Ask, Simplify, Explain, Accompany’: four verbs repeated at every visit.

## Test yourself

Think of the answer, then tap the question to see it.

## How do you ask about adherence to get an honest answer?

Normalize forgetting and ask about a concrete period: ‘Many people miss the odd dose; how many did you miss this week?’

## Which change to the therapy most simply improves adherence?

Simplifying the regimen: fewer doses a day and combinations in a single tablet.

## Why explore the patient's beliefs about the medicine?

Because intentional non-adherence often stems from doubts about need or fear of side effects, which education alone does not resolve.

## What is directly observed therapy and in which disease is it classic?

A health worker or community agent watches each dose being taken; it is classic in tuberculosis.

[Add to my cards (4)](https://durgical.app/estudiar/?add=/en/behavioral-science/how-to-improve-adherence/)

## Elsewhere in DurgiPedia

- [Medicines, allergies and habits: tobacco, alcohol and other substances](https://durgical.com/en/clinical-exam/medicines-allergies-and-habits-tobacco-alcohol-and-other-substances/)

## Connections

## Related 6

- [Adherence: what it is and why it fails](https://durgical.com/en/behavioral-science/adherence-what-it-is-and-why-it-fails/)
- [Motivational interviewing](https://durgical.com/en/behavioral-science/motivational-interviewing/)
- [Health literacy](https://durgical.com/en/behavioral-science/health-literacy/)
- [Communication skills: open questions, empathy and teach-back](https://durgical.com/en/behavioral-science/communication-skills-open-questions-empathy-and-teach-back/)
- [The health belief model](https://durgical.com/en/behavioral-science/the-health-belief-model/)
- [Operant conditioning: reinforcement and punishment](https://durgical.com/en/behavioral-science/operant-conditioning-reinforcement-and-punishment/)

## Related conditions 4

- [Arterial hypertension](https://durgical.com/en/conditions/arterial-hypertension/)
- [HIV infection and AIDS](https://durgical.com/en/conditions/hiv-infection-and-aids/)
- [Pulmonary tuberculosis](https://durgical.com/en/conditions/pulmonary-tuberculosis/)
- [Type 2 diabetes mellitus](https://durgical.com/en/conditions/type-2-diabetes-mellitus/)

[← All of behavioral science](https://durgical.com/en/behavioral-science/)

Educational content on behavior and the clinical relationship; not a diagnostic or treatment guide and no substitute for assessment by a health professional. If you or someone near you is at risk, seek help now from an emergency service or a mental-health helpline.

Sources: [CDC Grand Rounds: Improving Medication Adherence for Chronic Disease Management — Innovations and Opportunities](https://www.cdc.gov/mmwr/volumes/66/wr/mm6645a2.htm) (Centers for Disease Control and Prevention (MMWR), 2017); [Failure to take prescribed medicine for chronic diseases is a massive, world-wide problem](https://www.who.int/news/item/01-07-2003-failure-to-take-prescribed-medicine-for-chronic-diseases-is-a-massive-world-wide-problem) (World Health Organization, 2003).

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Representative model, for educational purposes only.

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Source: https://durgical.com/en/behavioral-science/how-to-improve-adherence/
License: CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). Cite as: DurgiPedia (durgical.com), https://durgical.com/en/behavioral-science/how-to-improve-adherence/