Relatively little research has been conducted on the effects of health care team and system-related
factors on adherence.Whereas a good patient-provider relationship may improve adherence (17),
there are many factors that have a negative effect.These include, poorly developed health services
with inadequate or non-existent reimbursement by health insurance plans, poor medication distribution
systems, lack of knowledge and training for health care providers on managing chronic diseases,
overworked health care providers, lack of incentives and feedback on performance, short consultations,
weak capacity of the system to educate patients and provide follow-up, inability to establish
community support and self-management capacity, lack of knowledge on adherence and of effective
interventions for improving it.