Pleio, a healthcare patient support company, has unveiled “The Hidden Enemies of Adherence: Mapping the Underminers Behind Every Missed Dose,” a report that breaks down the obstacles that impact patients’ adherence to their medication regimen.1

How did it gather the data? It’s based on more than 140,000 patient interactions that took place via its proprietary AI-powered platform. Known as OLLIE, the platform examines peer-to-patient conversations with the help of various behavioral models, such as the Barrier Blueprint model.

Mapping the hidden complexity of medication adherence

The aforementioned model goes beyond than just going through one’s standard checklist of obstacles. Instead, it maps out how seven intertwined dimensions of emotion, attitudes, knowledge, logistics, support, financial, and skills interact across 37 drivers and 85 barriers, to reveal the full complexity behind medication adherence.

Uncertainty, knowledge, and skills drive non-adherence

What stood out most was that patients are often less limited by cost—which many tend to believe is the primary non-adherence driver—than by uncertainty. Many lack the information, training, and reassurance needed to feel capable of managing their therapy successfully.

Pleio analysis concluded that:

• A majority of standard challenges relate to knowledge at 40.6%.
• This is followed by skills at 40.5%.

Regardless of the disease state, there was one main conclusion, which was that barriers hardly occur in isolation. Rather, when emotional challenges, limited understanding, and everyday barriers converge, hesitation can disrupt treatment even before it even starts.

"What we see so clearly in the data is how deeply patients need to feel supported," said Michael Oleksiw, CEO of Pleio. "Fear, hesitation, and doubt often overshadow financial barriers entirely. And without a human voice offering clarity and calm, even the medication already in a patient's hand may not lead to that first, meaningful dose."

The loneliness factor: How diagnosis undermines adherence

However, that is not to say that patient loneliness doesn’t directly undermine adherence and outcomes. In fact, emerging insights suggest that emotional and social factors may play a far greater role in adherence than previously understood.

“We've been doing this for 14 years and seeing improvement in medication adherence and loving what we're seeing, but kind of wondering, what's really driving this? asked Jen Butler, Pleio’s CCO in a video interview2 with Pharma Commerce. What is it that the patients are actually responding to: the information or the connection? Last spring, we were put in touch with Dr. Nobel, who is a Harvard Medical School faculty member, a public health expert, and author of Project UnLonely. Talking to him, we started making the connection of what's really driving adherence goes way beyond just tactical mechanical solutions and there's emotions at play. We fielded a study last April, where over 2,000 patients who had one chronic disease and also identified that they were struggling with loneliness, in some form or fashion, just feeling that perception of not having the connectivity that they desired.

“It’s just important to say that loneliness isn't just about feeling isolated, because some people— as we've discovered during the pandemic back in those times—actually like being alone. So it's that perception of not having that connectiveness, and in that survey that came back, the results to understand the significance were really impactful. We saw that upon diagnosis, over two-thirds of patients said that the diagnosis of their condition made them feel lonelier than they were previously.

References

1. Pleio Uncovers the Underminers of Adherence With AI-Driven Patient Insights. PR Newswire. November 20, 2025. Accessed December 3, 2025. https://www.prnewswire.com/news-releases/pleio-uncovers-the-underminers-of-adherence-with-ai-driven-patient-insights-302620804.html

2. Saraceno N. The Hidden Costs of Prior Authorizations and Patient Loneliness. Pharmaceutical Commerce. October 21, 2025. Accessed December 3, 2025. https://www.pharmaceuticalcommerce.com/view/hidden-costs-prior-authorizations-patient-loneliness