Delphi expert document on therapeutic adherence in patients with cardiovascular disease: Barriers, facilitators, and clinical implications

Medication adherence is a key factor in managing cardiovascular disease, as it directly influences clinical control, event prevention, and healthcare efficiency. This Delphi expert involving 118 experts in cardiology, internal medicine, and primary care, aimed to identify barriers, facilitators, and practical strategies to improve adherence in Spain. Fifty statements were evaluated in 2 rounds, followed by 15 local meetings with clinical experts to contextualize and interpret the conclusions. Consensus was reached on 49 statements (98.0%), emphasizing the need to measure and promote adherence systematically. The main barriers identified were polypharmacy, lack of care coordination, and medication costs, while strategies such as fixed-dose combinations, digital tools, health education and patient education were highlighted as key facilitators good adherence was acknowledged to reduce cardiovascular events, hospitalizations, and costs, improving patient quality of life. This document offers clinical and organizational recommendations to optimize therapeutic adherence in cardiovascular patients.