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Factors Influencing Patient Adherence

Patient adherence to chelation therapy is critical to treatment success, making it important to identify why patients do not always take their medicine as prescribed. There is a common misconception that the majority of non-adherence is due to patients simply forgetting to take medication. However, numerous studies have found this is not the case. In fact, in one patient survey study, 56% chose to discontinue due to financial hardship and 46% due to side effects. In the same study, only 12% of patients cited "problems remembering to take medication" as the reason for non-persistence.1,2

Other factors that may negatively impact patient adherence:1-3

  • Poor patient understanding of the disease and benefits of treatment
  • Patient's belief that a medication is not efficacious or "not working"
  • Patient's concerns regarding medication safety or tolerability
  • Poor patient understanding of proper administration
  • Poor access to appointments and medications
  • Poor HCP-patient communication
  • High medication costs
  • Dosing frequency: one study demonstrated a significant decrease in adherence with 3-times-daily versus once-daily dosing

Problems with adherence can happen at varying points in treatment, sometimes before the first prescription is even filled .3,4

Figure. Factors Influencing Patient Adherence.

Data on file. Novartis Pharma AG, Basel, Switzerland.


  1. Claxton AJ, et al. Clin Ther. 2001;23:1296-1310.
  2. McHorney CA et al. Health Expect. 2011;14:307-20.
  3. Osterberg L, Blaschke T. N Engl J Med. 2005;353:487-489.
  4. Data on file. Novartis Pharma AG, Basel, Switzerland.

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