REVIEW article
Front. Pharmacol.
Sec. Drugs Outcomes Research and Policies
Medication Adherence in Burn Care: A Systematic Analysis of Barriers and Interventions Using the WHO Framework
Jiaqi Lou 1
Ziyi Xiang 2
Xiaoyu Zhu 3
Jiliang Li 1
Guoying Jin 1
Shengyong Cui 1
Neng Huang 1
Xin Le 1
Youfen Fan 1
Qionghui Sun 1,4
1. Ningbo No 2 Hospital Burn Department, Ningbo, China
2. Rheinische Friedrich-Wilhelms-Universitat Bonn, Bonn, Germany
3. Ningbo University, Ningbo, China
4. Department of Nursing, Ningbo No.2 Hospital, Ningbo, China
Select one of your emails
You have multiple emails registered with Frontiers:
Notify me on publication
Please enter your email address:
If you already have an account, please login
You don't have a Frontiers account ? You can register here
Abstract
Abstract: Medication adherence in burn patients represents a complex clinical challenge shaped by intersecting biomedical, psychological, and sociocultural dynamics. Although advancements in burn care have substantially improved survival rates, the intricate pharmacological regimens essential for recovery— including antibiotics, analgesics, and metabolic modulators—frequently result in suboptimal adherence, particularly in outpatient settings. This systematic review applies the World Health Organization (WHO) framework across five adherence dimensions to analyze barriers and interventions specific to burn care. We systematically searched multiple databases and identified 78 studies meeting inclusion criteria. Our analysis reveals that medication adherence in burn care is influenced by a complex interplay of factors across all WHO dimensions. Socioeconomic barriers include limited health literacy (43% of caregivers), financial constraints, and cultural beliefs favoring traditional medicine (31% of Asian/African cohorts). Healthcare system barriers encompass inadequate access to specialized burn centers (68% of low-income countries lack such facilities) and workforce shortages. Condition-related challenges involve burn-induced hypermetabolism altering drug pharmacokinetics and psychological comorbidities (35-45% depression prevalence). Therapy-related complexities include polypharmacy (average 4.2 drug-drug interactions per patient) and demanding treatment regimens. Patient-related factors encompass cognitive impairments (12-18% of major burn cases) and trauma-related psychological barriers. Effective interventions identified include multidisciplinary care models, technology-enabled solutions (AI prediction models achieving 89% accuracy), culturally adapted approaches, and policy reforms. This review provides a comprehensive framework for developing targeted, multidimensional strategies to improve medication adherence in burn care across diverse settings and populations.
Summary
Keywords
adherence, Hypermetabolism, drug, pharmacokinetics, AI
Received
15 September 2025
Accepted
05 November 2025
Copyright
© 2025 Lou, Xiang, Zhu, Li, Jin, Cui, Huang, Le, Fan and Sun. 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: Xin Le; Youfen Fan; Qionghui Sun
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.