***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: BACKGROUND Nonadherence to physician treatment recommendations is an increasingly recognized cause of adverse outcomes and increased health care costs , particularly among patients with cardiovascular disease . Whether patient self-report can provide an accurate assessment of medication adherence in out patients with stable coronary heart disease is unknown . METHODS We prospect ively evaluated the risk of cardiovascular events associated with self-reported medication nonadherence in 1015 out patients with established coronary heart disease from the Heart and Soul Study . We asked participants a single question : " In the past month , how often did you take your medications as the doctor prescribed ? " Nonadherence was defined as taking medications as prescribed 75 % of the time or less . Cardiovascular events ( coronary heart disease death , myocardial infa rct ion , or stroke ) were identified by review of medical records during 3.9 years of follow-up . We used Cox proportional hazards analysis to determine the risk of adverse cardiovascular events associated with self-reported medication nonadherence . RESULTS Of the 1015 participants , 83 ( 8.2 % ) reported nonadherence to their medications , and 146 ( 14.4 % ) developed cardiovascular events . Nonadherent participants were more likely than adherent participants to develop cardiovascular events during 3.9 years of follow-up ( 22.9 % vs 13.8 % , P = .03 ) . Self-reported nonadherence remained independently predictive of adverse cardiovascular events after adjusting for baseline cardiac disease severity , traditional risk factors , and depressive symptoms ( hazards ratio , 2.3 ; 95 % confidence interval , 1.3 - 4.3 ; P = .006 ) . CONCLUSIONS In out patients with stable coronary heart disease , self-reported medication nonadherence is associated with a greater than 2-fold increased rate of subsequent cardiovascular events . A single question about medication adherence may be a simple and effective method to identify patients at higher risk for adverse cardiovascular events This study aim ed to assess the predictors of non-adherence to antihypertensive medications in northern United Arab Emirates . In a cross-sectional , multicentre study in Ajman Emirate , 250 patients with hypertension were r and omly selected from outpatient clinics . Participants answered an interview question naire about sociodemographic and clinical data and completed the Morisky medication adherence scale . Non-adherence to antihypertensive medication was reported by 45.6 % of patients . Sociodemographic predictors of non-adherence were sex and number of children . Therapy-related predictors of adherence were hospital admissions , number and cost of medications , medication perceived effectiveness and use of traditional remedies . Patient-related predictors of non-adherence were forgetfulness , method of identifying medication and poor awareness of hypertension complications . Health-care-related predictors were regular follow up at clinics , education and counselling , frequency of changing medication by physicians and awareness of physicians ' instructions BACKGROUND Persistence and compliance are different aspects of the broader concept of adherence to drug treatment . In a prior study , determinants of nonpersistence in a group of patients newly prescribed antihypertensive medications were examined . OBJECTIVE To determine noncompliance among those who were persistent with therapy . METHODS A prospect i ve cohort study was conducted , in which individuals prescribed a new antihypertensive monotherapy were identified through a network of 173 pharmacies . Participants were interviewed by telephone twice during a three-month period . At the end of this period , individuals who reported still taking the medication initially prescribed were included in the analysis . Self-reported noncompliance was measured at three months . Data were analyzed using a multivariate logistic regression model . RESULTS Of 509 eligible participants , 118 ( 23.2 % ) reported noncompliance with their drug treatment . Noncompliance was significantly associated with the use of angiotensin-converting enzyme inhibitors ( adjusted OR [ AOR ] 3.0 ; 95 % CI 1.17 to 7.92 ) compared with the angiotensin II receptor blocker losartan , and with the belief that hypertension is not a risk factor for cardiovascular diseases ( AOR 2.0 ; 95 % CI 1.21 to 3.33 ) . On the other h and , noncompliance was inversely associated with the use of more than four pills of medication per day ( AOR 0.3 ; 95 % CI 0.15 to 0.64 ) . CONCLUSIONS Compliance with drug treatment could be improved by proper selection of medication , and by attempts to correct the false perceptions patients may have about hypertension . Further research is needed to better underst and the clinical significance of a higher number of pills as a predictor of good compliance . Further research is also needed using different means of measuring noncompliance BACKGROUND : Adherence to medication is a critical factor in the continued health and well-being of patients with hypertension . Patients ' acceptance of medical advice and information may be influenced by their subjective beliefs about their health condition ; therefore , it is essential that their beliefs be taken into account when giving health advice or medical treatment . OBJECTIVE : To determine whether a relationship exists between illness attribution , perceived control , and adherence to antihypertensive medications . METHODS : A prospect i ve , cross-sectional survey of hypertensive patients was conducted at the University of Michigan Medical Centers , Hypertension Clinic , Ann Arbor , MI . One hundred two patients with a goal to reduce their blood pressure were included in the study .  Written and follow-up telephone survey questions assessing patients ' illness attributions , perceived control , and medication adherence were administered . Associations between these variables were analyzed using correlation analyses . RESULTS : The majority of patients ( 67.7 % ) were adherent with their hypertensive medications . Patients indicated that modifiable variables were the most common attribution believed to cause hypertension ; however , there was no significant relationship to medication adherence . A significant inverse relationship was found between perceived control over hypertension and medication adherence ( p < 0.01 ) . CONCLUSIONS : The findings suggest that patients ' greater perception of control over trying to reduce blood pressure may result in decreased reliance on medications and subsequent nonadherence to drug therapy . Implication s of these findings on pharmacy practice are discussed 
    Output:
    
AND RELEVANCE The results of this review suggest that access to insurance or another program that assists with medication costs was a protection factor for non-adherence .
On the other h and , a high frequency of dosing was a risk factor for non-adherence .