The research agenda, summaries of the conference presentations, and a background paper on adherence research with a bibliography is in the Conference Report, which I am happy to make available to you. We know that patients have a hard time taking pills. We know that the more complex the regimen, the harder it is to comply. Adherence levels fall as the number of pills, the number of drugs, and number of times per day you take pills increases. Required changes in diet and the length of time a patient is expected to be on therapy will effect adherence levels.
Research shows that adherence gets harder the longer the patient is on treatment.
Changes in routine, depression, beliefs about health care and medicine, and self-esteem will all affect adherence levels. Communication between the physician and the patient is cited as a key factor in adherence, as is good patient understanding on the logistics and purpose of therapy. In HIV, the challenge is particularly rough. The regimens are complex, and patients are expected to start therapy early in the course of the disease and stay on therapy for the rest of their lives. The side effects of therapy will interfere with quality of life, if not life itself.