REVIEW article
Front. Pharmacol.
Sec. Drugs Outcomes Research and Policies
Volume 16 - 2025 | doi: 10.3389/fphar.2025.1570359
This article is part of the Research TopicThe Continuing Challenge of Medication AdherenceView all 5 articles
Clinical and economic consequences of medication nonadherence: a review of systematic reviews
Provisionally accepted
- 1University Medical Center Groningen, Groningen, Netherlands
- 2Altınbaş University, Istanbul, Istanbul, Türkiye
- 3Syreon Research Institute, Budapest, Hungary
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Background: Medication efficacy observed in clinical trials may differ from its effectiveness during real-world usage. Medication nonadherence is one of the key factors being responsible for this efficacy-effectiveness gap. The World Health Organization estimated that only 50% of chronic medication users is adherent and nonadherence results in both negative health outcomes for the patient and higher societal costs. An overview of the consequences across disease groups may allow some comparison and could contribute to identification of priority clinical areas. Objective: We aimed to provide an overview the impact of nonadherence on clinical and economic outcomes. Method: We narratively reviewed systematic reviews published between 2014 and 2024 on the effect of medication nonadherence on clinical and economic outcomes. Results: Overall, 43 systematic reviews were identified, including over 410 original studies on clinical outcomes and 174 on economic outcomes, covering different clinical areas (e.g. organ transplantation, cardiovascular diseases, diabetes, depression and chronic lung diseases [asthma/COPD]). Beyond diminished treatment effects, medication nonadherence has been associated with elevated mortality, increased healthcare utilization (including hospital admissions), and higher direct (e.g. more healthcare provider visits) and indirect financial cost burden (e.g. work productivity losses due to absenteeism and presenteeism) for patients and society. Conclusion: Medication nonadherence is associated with poor clinical and economic outcomes across disease areas. Given the significant impact of nonadherence, raising awareness among healthcare professionals and policy makers, early stakeholder engagement in intervention design, and eventually implementation of cost-effective interventions on both health policy, system and individual patient level are urgently required.
Keywords: Medication Adherence, economic outcomes, Clinical impact, Burden, Cost-Effectiveness, chronic diseases AMI, ACS, CAD
Received: 03 Feb 2025; Accepted: 03 Jun 2025.
Copyright: © 2025 Achterbosch, Aksoy, Obeng, Ameyaw, Ágh and Van Boven. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Job FM Van Boven, University Medical Center Groningen, Groningen, Netherlands
Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.