Which factor(s) contribute to decreased client adherence to medications? Select all that apply.

A. Taking extended-release medications: Extended-release formulations are typically taken once daily, which can actually improve adherence by reducing dosing frequency. These formulations maintain stable plasma drug levels, lowering the likelihood of missed doses and enhancing pharmacologic consistency rather than contributing to nonadherence. B. Increased cost of the medication: High medication costs are a major barrier to adherence because clients may ration doses, skip medications, or fail to refill prescriptions. Financial constraints can interfere with continuous therapeutic drug levels, increasing the risk of treatment failure and worsening disease outcomes. C. Fear of side effects from the medication: Anxiety about potential adverse effects can significantly reduce adherence, as clients may intentionally lower doses or discontinue medication. Fear often stems from past negative experiences or misunderstandings about expected versus serious effects, impacting consistent pharmacologic therapy. D. Understanding benefits of the medication: Understanding therapeutic benefits typically improves adherence by increasing the client’s motivation to continue treatment. Knowledge of how the drug controls disease progression or symptoms promotes self-management and strengthens medication-taking behaviors. E. Having trust in the healthcare provider: A strong provider–client relationship enhances communication and confidence in prescribed treatments, leading to better adherence. Trust increases the likelihood of clients following instructions, reporting concerns early, and maintaining long-term medication routines.