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Analysis of factors affecting adherence to therapy in patients with chronic diseases

Antoaneta Tsvetkova, Silvia Mihaylova, Desislava Aleksandrova



Treatment of chronic diseases is a long-lasting and ongoing process that requires continuous pharmacotherapy. Adherence indicates the extent to which patient behaviour (in terms of medicine intake, diet compliance and change of life) corresponds to the advice received by a medical professional.


The aim of this article is to study and analyse the opinion of pharmacists, working in hospital and community pharmacies, on patients’ level of adherence to the prescribed drug therapy and to identify the leading socioeconomic, pharmacotherapeutic and pharmacoeconomic factors affecting adherence in patients with chronic diseases.


Materials and Methods

This national study was conducted in May 2020. Anonymous individual questionnaires were distributed to Masters of Pharmacy and assistant pharmacists. The survey was conducted online by a sociological method, using a Google form. Data was processed through software included in the Google forms. Charts were created with MS Excel and MS Word.


The results confirm the European and global tendency towards a low level of patient adherence to drug therapies—84.7% of pharmacists responded that only half of the patients adhered to the therapy. Respondents reported the high price and low reimbursement rate of medicines as objective reasons for non-purchasing medicinal products (79.8%). Our survey results indicate that adherence to therapy in patients with chronic diseases in Bulgaria remains a significant issue due to various socioeconomic and pharmacotherapeutic factors.


Adherence to the prescribed pharmacotherapy is crucial for achieving the therapeutic results.


patient adherence, chronic diseases, drug therapies, socioeconomic and pharmacotherapeutic factors

Full Text


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About The Authors

Antoaneta Tsvetkova
Medical university of Varna

Medical College

Silvia Mihaylova
Medical university of Varna

Medical College

Desislava Aleksandrova
Medical university of Varna

Medical College

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