Refusal of pharmacological treatment: prevalence and clinical importance

• Published in: Rat͡s︡ionalʹnai͡a︡ farmakoterapii͡a︡ v kardiologii Vol. 21; no. 2; pp. 143 - 148
• Main Authors: Martsevich, S. Yu, Kutishenko, N. P., Kalaydzhyan, E. P., Lukina, Yu. V., Zagrebelnyy, A. V., Tsaregorodtseva, V. V., Afonina, O. S., Zolotareva, N. P., Ginzburg, M. L., Drapkina, O. M.
• Format: Journal Article
• Language: English
• Published: Столичная издательская компания 30.06.2025
• Subjects: absolute non-adherence; cardiovascular diseases; cardiovascular outcomes; prevention of absolute non-adherence; reasons for treatment refusal; registries; treatment refusal
• ISSN: 1819-6446; 2225-3653
• DOI: 10.20996/1819-6446-2025-3175

This article addresses the issue of refusal of pharmacological treatment. Limited literature data concerning the clinical significance of treatment refusal in patients with internal organ diseases are presented. Original foreign studies focusing on treatment refusal in patients with chronic non-communicable diseases, particularly those with cardiovascular conditions, are rare. Most of these studies examine not only the refusal to take medications but also the discontinuation of specific therapeutic procedures, as well as the underlying reasons for such refusals. An analysis was conducted of Russian prospective clinical registries for cardiovascular diseases, which have recorded instances of complete cessation of pharmacological therapy or the phenomenon of absolute non-adherence. The frequency of complete discontinuation of treatment ranged from 1% to 10.1%. The main reasons for the complete discontinuation of medication included satisfactory health status, reluctance to engage in prolonged medication use, and high costs associated with treatment. It is demonstrated that complete discontinuation of therapy may have a negative impact on disease outcomes. Thus, a certain proportion of patients with cardiovascular diseases completely refuse treatment, despite being provided with recommendations. This can be partly attributed to the patients’ relatively good well-being. Additionally, poor awareness regarding the efficacy of prescribed medications seemingly plays a significant role. Therefore, a promising approach to prevent the phenomenon of absolute non-adherence among patients with chronic non-communicable diseases is regular monitoring and educating them about the fact that the prescribed therapy can not only alleviate disease symptoms but also improve the prognosis and reduce the risk of complications.