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Another study [ 32] compared four age groups (range 57 89) and found that age group 35 56 had the highest level of adherence and age group 56 64 had the lowest level of adherence (Fig. 2).
Defining adherence as a continuous measure made the exclusion restriction more plausible, as the lowest level of adherence could be defined as receiving no treatment, a level at which being allocated to either treatment group should really have no effect on outcome.
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The lowest levels of adherence were observed for component 10: unhelpful thinking (median 1.67, IQR 1.67 2.00), and component 2: pain information (median 1.75, IQR 1.42 2.00).
Long term commitment to CQI was also associated with improvements in health centres at the lower range of performance, with an increase in the lowest levels of adherence to best practice guidelines from less than 20% to approximately 40% over three audit cycles.
The low level of adherence "is an ongoing disappointment," said Dr. Lee Goldman, a professor of medicine and epidemiology and a dean at Columbia University Medical Center who was one of the authors of an accompany editorial in the New England Journal of Medicine, entitled "Improving Adherence — Money isn't the Only Thing".
HDS use was significantly associated with a low level of adherence to conventional medicine.
Patients who chewed khat and drank alcohol had a reportedly low level of adherence to antipsychotic medications.
However, since our findings indicate a low level of adherence to guidelines, this adds weight to the concern that doctors may be under counseling for CVD prevention.
Those with a medium level of adherence to conventional medication were less likely to use HDS compared with those with a low level of adherence (OR 0.53, 95% CI 0.32-0.87).
The results show a lower mortality rate in cases where there was total adherence to the package of interventions in the first 6 hours, but we still have low level of adherence to this package (33%).
The effectiveness of HAART highly depends on how adherent patients are on their treatment [ 22, 23] but low level of adherence to first line treatment is a common phenomenon in low income countries including Ethiopia [ 24, 25].
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