CONCLUSIONS
DISEASES
Reasons why patients do not adhere to prescriptions are many and varied. Some reasons center around the ability of HCWs to effectively communicate the basic prescription instructions to the patient and for the patient to understand these instructions. Beyond this, various social and cultural factors pull patients away from adherence, which we consider may be influenced by communication messages but will likely also need other reinforcing interventions. However, some fundamental problems such as the financial pressures faced by poor communities, and an overstretched health system, will require deeper and wider-reaching solutions.Existing systematic reviews exploring behavior drivers for medicine adherence across diseases highlight the limited number of studies conducted in LMICs. In their review of articles published between 1970 and 2005, Jin et al [According to Jin et al, “More studies on factors influencing compliance in these countries or regions would be helpful to fill in the knowledge gap and contribute to formulating international strategies for countering non-compliance” [Within the available literature, overall reflecting high-income and upper-middle-income countries, we see a commonality in behaviors identified in this study, with determinants such as costs and income, patient knowledge, and difficulty in getting prescriptions filled [This study highlights the complex interwoven web of factors, including cultural factors, that interact with each other and push and pull on the patient/caregiver adherence behavior. We suggested that an in-depth understanding of the interrelation of these factors is needed to design effective interventions.The discussion above focused on identifying behavioral drivers that were used to develop a T&C intervention in support of prescription adherence. However, as the findings demonstrate, other additional forms of intervention will be required. In the second phase of the study we investigated an intervention design to address prioritized behavior drivers of nonadherence, using behavioral frameworks and a modified version of the behavior change wheel [We consider that the behavioral drivers described above, and summarized in the 