Non-adherence is a problem that has many determinants and health professionals, the health care system, the community and the patients must share the responsibility for adherence. Various dimensions affecting on adherence figure (21), and these have been grouped into the five dimensions through two main factors, are:
1- Medical factors: three medical factors face the patient to affecting on to health therapy:
a. Therapy related factors:
Many therapies-related factors affect adherence. Most notable are those related to the complexity of the medical regimen, duration of treatment, previous treatment failures, frequent changes in treatment, the immediacy of beneficial effects, side-effects, and the availability of medical support to deal with
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A patient 's motivation to adhere to prescribed treatment by increasing the perceived importance of adherence, and strengthening confidence by building self-management skills, are behavioral treatment targets that must be addressed concurrently with biomedical ones if overall adherence is to be improving (Mathevula, 2013a and Mathevula, 2013b).
c. Health care team/ health system related factors:
Relatively little research has been conducted on the effects of the health care team and system-related factors on adherence. Whereas a good patient-provider relationship may improve adherence, there are many factors that have a negative effect. These include, poorly developed health services with inadequate or non-existent reimbursement by health insurance plans, poor medication distribution systems, lack of knowledge and training for health care providers on managing chronic diseases, overworked health care providers (Stroke Association.