According to a new review published in The Cochrane Library, only about half of all patients who are prescribed medication that they administer themselves actually take their medication as prescribed. Many stop taking their medications all together, and others don’t take it according to instructions.

The researchers looked at data from 182 trials. The trials studied a wide range of medical conditions, from HIV to psychiatric disorders There were wide-ranging effects on adherence and patient health. Because of this, it was difficult for the researchers to come to specific conclusions.

“The studies varied so much in terms of their design and their results that it would have been misleading to try to come up with general conclusions,” said lead researcher, Robby Nieuwlaat of the Department of Clinical Epidemiology and Biostatistics at McMaster University in Hamilton, Canada. “Based on this evidence, it is uncertain how adherence to medication can be consistently improved. We need to see larger and higher quality trials, which better take in account individual patient’s problems with adherence.”

“This review addresses one of the biggest challenges in healthcare,” added Dr. David Tovey, Editor in Chief of the Cochrane Library. “It’s a real surprise that the vast amount of research that has been done has not moved us further forward in our understanding of how to address this problem. With the costs of healthcare across the world increasing, we’ve never needed evidence to answer this question more than we do now.”

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