Social determinants associated with therapeutic adherence in patients with non-communicable chronic diseases: an analytical study

Abstract

Non-communicable chronic diseases, including diabetes mellitus, arterial hypertension, cardiovascular diseases and chronic respiratory conditions, constitute a major public health priority due to their high prevalence, morbidity and mortality rates, and the substantial burden they place on healthcare systems. In this context, therapeutic adherence represents a fundamental component for effective clinical control and the prevention of disease-related complications; however, adherence is influenced by multiple factors that extend beyond the clinical domain. The aim of this study was to analytically examine the available scientific evidence on the social determinants associated with therapeutic adherence in patients with non-communicable chronic diseases, in order to understand their influence on treatment follow-up and their relevance within healthcare provision. A qualitative, analytical and documentary approach was adopted, focused on the critical systematisation of the scientific literature, without the implementation of interventions or the direct measurement of variables. The analysis identified that factors such as educational level, socioeconomic status, employment stability, access to healthcare services and family support exert a significant influence on therapeutic adherence, as they condition treatment comprehension, patient autonomy and active participation in the care process. These findings reinforce the need to address therapeutic adherence from a comprehensive perspective that incorporates the social determinants of health into the care of patients with non-communicable chronic diseases.