Adherence to treatment: the key for avoiding long-term complications of diabetes.

Behavioral changes and adherence to pharmacological treatment are essential for improving the prognosis in chronic illness. Lack of adherence to treatment is a common problem in every practice and many patients drop out of care prematurely. The present article is a review of our knowledge regarding adherence to treatment in type 2 diabetic patients and the strategies we can implement to improve it. Diabetes regimens contain many aspects that make compliance difficult; it is a chronic disorder, lifestyle changes are required, and treatment may be complex, intrusive and inconvenient. Prevention, instead of symptom reduction or cure, is usually the main goal. Successful interventions to improve adherence are labor intensive but ultimately cost effective. Educating patients, keeping regimens as simple as possible, negotiating priorities, monitoring adherence and attendance at appointments and reinforcing the patient's efforts to adhere at each visit provide practical and effective help. Clinicians must understand that failure to achieve the therapeutic goals might be related to inadequate self-management. Instead of changing prescriptions, increasing drug dosage, or switching or adding medications, clinicians should consider counseling patients on how to improve adherence.