While 'hygiene' practice (i.e. the specific actions we take to prevent transmission of disease) has been shown to be associated with reduced infection rates, observational studies indicate that consumer adherence to basic hygiene rules remains poor.
Furthermore, both policy and clinical interventions have been shown to be less effective for the poor and disadvantaged due to issues such as access, screening, provider compliance and consumer adherence [ 13].
Consumers' adherence to their prescribed medications was measured by manual pill count, self-report of medication adherence, and surrogate biochemical markers of disease control.
A few examples illustrate both the complexity and diversity: interventions to improve consumers' adherence to medicines could include instruction, counselling or psychological therapy, simplified dosing, self-monitoring, reminders, lay health mentoring, crisis or family interventions, and many others, and these can each be delivered alone or as complex multifaceted interventions [ 4].
The HBM model encompasses modifying or enabling psychosocial influences that affect a consumer's adherence to recommended health actions.
When multiple treatments are required for different health problems, medication-related concerns such as adherence, drug interactions and side effects, can be perceived as more troublesome to consumers than the treatments themselves [ 4, 5].
Target consumer and provider adherence rates were calculated based on the assumption that public education would not improve adherence to 100% but by 50% of the current deficit (Tables 1 and 3) [38-41].
Additional health gain (of an estimated 12.5%) could be realised by enhancing consumer education and therefore adherence to such non-specific drug treatment.
While the focus of this review is on factors affecting consumers, we acknowledge that adherence is a complex and dynamic phenomenon, which relates to consumers, providers, health systems and broader socio-economic and political contexts.
This paper outlines the development of a consumer-centred Medicine Self- Management Intervention (MESMI), designed to improve blood pressure control and medication adherence in consumers with diabetes and chronic kidney disease recruited from specialist outpatients' clinics.
The effective coverage of programs depends critically on the access and targeting of populations and vulnerable groups most at risk of malaria, the degree of compliance of the provider, and adherence by the consumer.
