title: Aiming at strategies for a complex problem of medical nonadherence.
abstract: The deteriorating health of the population and the increasing prevalence of chronic diseases are global problems whose causes are multifactorial and complex. The Western lifestyle does not promote healthy living, and the consequences are most devastating when social inequalities, together with the economic and population explosion of recent decades, are considered. The expansion of poor nutritional habits, obesity, sedentarism, and hypertension are increasingly contributing to the development of a cardiovascular disease epidemic. Recent data on the rates of compliance with lifestyle modification and adherence to prescribed medication are alarming. Over 50% of patients, on average, decide to abandon the treatment prescribed, and the objectives to improve their habits (quit smoking, lose weight, or engage in physical activity) are met by an equal or lower percentage. Beyond the impact it has on individual health, it carries a huge economic cost, as it is associated with a failure in achieving therapeutic goals, higher rate of hospitalization, and death. Improving communication between doctors and patients, the active involvement of other health professionals, and the development of combination drug formulations (polypill) are potential strategies for improving adherence and reducing costs.
authors.affiliation: Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA; Marie-Josée and Henry R. Kravis Cardiovascular Health Center, Icahn School of Medicine at Mount Sinai, New York, NY, USA. Electronic address: jmcastellano.cardio@gmail.com.
authors.forename: Jose M
authors.initials: JM
authors.lastname: Castellano
authors.affiliation: Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA; Marie-Josée and Henry R. Kravis Cardiovascular Health Center, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
authors.forename: Robert
authors.initials: R
authors.lastname: Copeland-Halperin
authors.affiliation: Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA; Marie-Josée and Henry R. Kravis Cardiovascular Health Center, Icahn School of Medicine at Mount Sinai, New York, NY, USA; Centro Nacional de Investigaciones Cardiovasculares (CNIC), Madrid, Spain.
authors.forename: Valentin
authors.initials: V
authors.lastname: Fuster