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[The prescription of treatment and the problem of adherence to the care on the part of the patient].

Poor adherence to treatment contributes significantly to treatment failures in medical care. The extent of the problem and its impact are considerable, by affecting patients, society and the health care system. Studies examining contributing factors have focused on patients' sociodemographic characteristics, features of the treatment regimen and disease state. When viewed in isolation, these variables have little if any descriptive or predictive value. It is difficult to identify which factors contribute to non-adherence, in any particular patient, without carefully interviewing the patient, and the solutions to remove barriers to adherence and to facilitate prescription observations must be individually tailored. Patient's beliefs, expectancies and representations of illness and treatment play a central role in determining the degree of adherence and the level of resistance to educational interventions; for this reason, during the medical interview, the first task is pick-up the cues of patient's representation to identify their features. In this perspective, the appropriate style of interaction is the biopsychosocial approach.