'Take as directed'--strategies to improve adherence to cardiac medication.

In patients with cardiovascular diseases, adherence to medication is a fundamental prerequisite for pharmacological therapy to be effective. Nonadherence to medication is a major public health problem that compromises the effectiveness of therapies and results in suboptimal clinical outcomes. The behaviour of nonadherence is complex and is strongly influenced by an interaction between various factors, such as patient education, communication between patients and physicians, drug dosing schedules, and access to health care. Interventions have been implemented to target these barriers to adherence; however, individual interventions have generally been associated with fairly modest improvements in adherence. Financial incentive schemes and modern technology, such as mobile telephone applications, are being harnessed as novel strategies to improve adherence. Ultimately, multifaceted strategies tailored to individual patients are likely to be required to improve long-term adherence to medication and consequently enhance patient health.