Management of adherence to prescribed medication.

Nonadherence is a major problem for long-term use of drugs affecting lipid metabolism. Effective programs for comprehensive management of adherence are available. Their administration and operation can be readily integrated within the usual operations of both large and small clinical trials. The programs are subject to quality control and, hence, can be administered effectively. The cost of a comprehensive adherence program is approximately 10% of the conventional cost of clinical trials, varies according to the nature and number of adherence tests, and is probably totally recovered through resultant economies. All of the elements of the adherence program can be adapted to private practice. The relative risks of nonadherence to drugs affecting lipid metabolism are estimated from analyses of four regimen characteristics.