While inflammatory rheumatic diseases are primarily treated pharmacologically, lifestyle factors and nonpharmacological interventions play a crucial role in predominantly degenerative musculoskeletal disorders. Interestingly, depending on the study, about 30–80% of patients do not adhere to their prescribed medication, fail to follow nonpharmacological treatment recommendations in daily life, or even stop attending follow-up appointments altogether. Patients report a wide range of reasons for this nonadherence, from lack of trust in the competence of healthcare professionals and rejection of certain measures, to declining motivation for physical activity or behavioral change over time [13]. However, when treatment recommendations are not followed, poorer outcomes are to be expected. Adherence means that patients implement the recommended treatments in everyday life as agreed upon, for example, taking medications correctly, performing exercises, or keeping appointments. Adherence is a behavior that can vary across age, life stage, and disease course. In children, adherence is mainly a collaborative process between parents, the child, and the healthcare team. Initially, parents hold primary responsibility, while the child is gradually introduced to treatment routines and adherence. Adolescence represents a particularly critical transition period, during which responsibility for treatment, and therefore for adherence, is increasingly transferred to the young person. In adulthood, adherence is more strongly influenced by individual attitudes, life circumstances, and trust in the healthcare team. Healthcare professionals play a key role at all stages by communicating with empathy, providing clear and comprehensible information, and defining shared treatment goals. The European League Against Rheumatism (EULAR) has published practical “points to consider” for adults; however, similar guidance for children and the transition to adult care is still lacking. Promoting adherence remains an interdisciplinary task that requires time, sensitivity, and appropriate structural conditions.
