Physicians, pharmacists and patients' compliance with chronic treatment in Bulgaria.

PURPOSE: To study the patient-physician and patient-pharmacist interrelation in order to reveal the systematic factors that influence patients' compliance. METHODS: Standard individual questionnaires were developed and used to assess compliance and non-compliance among different categories of patients suffering from chronic diseases. RESULTS: There is a relatively good communication between the patients and the health-care givers but in order to improve compliance (adherence) further, this level of communication has to be improved. The main reasons for non-adherence were: the high cost of drugs, the complexity of the daily regimen, negligence, and distrust of treatment. Insufficient information in the patient information leaflet, together with an inappropriate drug formulation also appear to be important factors that cause non-compliance. This is especially so, when patients have to receive more than one drug, or medications in different dosage forms, and it is particularly marked when elderly people are involved. CONCLUSION: Despite the comparatively high level of compliance found in this study (50-92%), there are possibilities for individualization of treatment that merit attention in order that the level of compliance can be improved.