Advances in medical therapies increase at an astounding rate, with more diseases than ever amenable to effective treatment. There is, however, a danger that these benefits may not be fully realised as a result of the failure of patients actually to take the medications prescribed for them. It has been estimated that typically up to half of all medications are not taken at all.1
This situation is not new and the growing body of research undertaken in this field (which amounts to very little when compared with the vast quantities on the effects of the actual medications themselves) reveals a number of issues surrounding medication‐taking behaviour. At the heart lie critical matters, such as the language and terminology that healthcare practitioners use with patients, the manner and relationship that are fostered between the two parties, and finally, the perspective of the patient who ultimately has to take the medication.
Although we may be stating the obvious, we must point out that unless patients take their prescribed medication appropriately, their overall health will fail to benefit. As clinical evidence grows, the case for treating conditions becomes clearer and stronger. For example, with regard to the treatment of hypertension, the long‐term advantages of pharmacological antihypertensive treatments for reducing morbidity and mortality from cardiovascular events are well known.2
In ophthalmology, an analogous group of chronic disease patients are those with glaucoma. Until recently, convincing evidence was not to hand, but now there are excellent studies that show that lowering intraocular pressure improves the outcome3
and reduces the rate of progression from ocular hypertension to glaucoma.4
Lowering the intraocular pressure in the first instance is routinely done pharmacologically with the instillation of topical drops. If the intraocular pressure is reduced adequately then patients are expected to remain on them indefinitely.3
An understanding of medication‐taking behaviour is, therefore, desirable. As evidence for this in medicine as a whole, we need look no further than to the impact of non‐adherence to therapy in the United States, where estimates of the approximate cost in additional hospital admissions is a staggering US$100 billion a year.5
Given the importance and seriousness of poor adherence to medication regimes, the World Health Organisation published an evidence‐based guide in 20036
for healthcare managers and policymakers to improve strategies of adherence. These problems are present in all aspects of medicine and are equally applicable to a wide range of acute and chronic diseases.