Prevalence and predictors of medication non-adherence in some common non-communicable chronic diseases and cancers: a comparative study

Shakeel A. Mir, Danish Shakeel


Background: Adherence is a key factor in the success of all pharmacological therapies. Medication non-adherence is an extremely common barrier to achieve positive health outcomes. The present study aims to compare medication non-adherence in some common chronic diseases and cancers and also to assess various factors influencing it.

Methods: Pre-validated questionnaires based on general medication adherence scale (GMAS) were equally distributed among 300 patients suffering from chronic illnesses and cancers. 270 patients returned completely filled questionnaires.

Results: The study population consists of 53.33% men and 46.66% women.55.55% patients were literate. 70.37% of patients were from rural areas. 61.48% were taking 2-4 drugs. As compared to 14.81% males 18.51% of females had poor or low adherence. Only 0.74% of young patients (<30 years) had poor/low adherence as compared to 16.29% each in other age groups. Rural patients had poor adherence as compared to patients from urban areas. As compared to 31.85% illiterate patients, only 16.29% of literate patients had poor or low adherence. Adherence was better in patients taking more than one drug. Statistically, a significant correlation was found between gender, age, level of education, and area of residence. Duration of treatment, the number of drugs, and the frequency of dosage were not found significantly correlated with adherence. Patients suffering from malignancies had higher medication adherence as compared to chronic illnesses.

Conclusions: Medication non-adherence is common in patients with chronic diseases and cancers that are treated with unsupervised oral antineoplastic drugs. The complex problem of non-adherence calls for interventions at various levels.


Medication, Adherence, Oral antineoplastics, Treatment, Cancers, Chronic diseases

Full Text:



E. Sabaté, Adherence to Long-Term Therapies: Evidence for Action, World Health Organization, Geneva, Switzerland, 2003. Available at: Accessed on 28 June 2020.

Jimmy B, Jose J. Patient medication adherence: measures in daily practice. Oman Med J. 2011;26(3):155.

Cutler RL, Fernandez-Llimos F, Frommer M, Benrimoj C, Garcia-Cardenas V. Economic impact of medication non-adherence by disease groups: a systematic review. Br Med J. 2018;8(1):e016982.

Partridge AH, Avorn J, Wang PS, Winer EP. Adherence to therapy with oral antineoplastic agents. J Nat Cancer Instit. 2002;94(9):652-61.

Foulon V, Schöffski P, Wolter P. Patient adherence to oral anticancer drugs: an emerging issue in modern oncology. Acta Clin Belg. 2011;66(2):85-96

Gruszczyńska M Sosnowska MB,Szemik S.Selected psychological aspects and medication adherence in oncological patients.Cancer Med. 2020;9(3):943–50.

Culig J, Leppée M. From Morisky to Hill-bone; self-reports scales for measuring adherence to medication. Collegium Antropologicum. 2014;38(1):55–62.

Osterberg L, Blaschke T. Adherence to medication, N Engl J Med. 2005;353:487-97.

Naqvi AA, Hassali MA, Rizvi M, Zehra A, Iffat W, Haseeb A, et al. Development and validation of a novel General Medication Adherence Scale (GMAS) for chronic illness patients in Pakistan. Frontier Pharmacol. 2018;9:1124.

Boyle D. Enhancing patient adherence to improve outcomes with oral chemotherapy proceedings from a symposium at the 22007 hematology/oncology pharmacy association annual conference. US Pharm 2007;32:1–8

Foulon V, Schöffski P, Wolter P. Patient adherence to oral anticancer drugs: an emerging issue in modern oncology. Acta Clin Belg. 2011;66(2):85-96.

Granger BB Ekman I Granger CB Ostergren J Olofsson B Michelson E et al. Adherence to medication according to sex and age in the CHARM programme Eur J Heart Fail. 2009;11:1092-8.

Manteuffel M, Williams S, Chen W, Verbrugge RR, Pittman DG, Steinkellner A. Influence of patient sex and gender on medication use, adherence, and prescribing alignment with guidelines. J Wom Heal. 2014;23(2):112-9.

Gast A, Mathes T. Medication adherence influencing factors—an (updated) overview of systematic Reviews. Syst Rev. 2019;8:112.

Krueger K, Botermann L, Schorr SG, Griese-Mammen N, Laufs U, Schulz M. Age-related medication adherence in patients with chronic heart failure: a systematic literature review. Int J Cardiol. 2015;184:728-35.

Rolnick SJ, Pawloski PA, Hedblom BD, Asche SE, Bruzek RJ . Patient characteristics associated with medication adherence. Clin Med Res 2013;11:54–65.

Martin MY, Kim YI, Kratt P, Litaker MS, Kohler CL, Schoenberger YM, et al. Medication adherence among rural, low-income hypertensive adults: a randomized trial of a multimedia community-based intervention. Am J Health Promot. 2011;25:372–8.

Arbuckle C, Tomaszewski D, Aronson BD, Brown L, Schommer J, Morisky D, et al. Evaluating factors impacting medication adherence among rural, urban, and suburban populations. J Rural Health. 2018

Grant RW, Devita NG, Singer DE. Polypharmacy and medication adherence in patients with type 2 diabetes. Diabet Car. 2003;26:1408–12

Murray MD, Kroenke K. Polypharmacy and medication adherence: small steps on a long road. J Gen Intern Med. 2001;16:137–9.