Wednesday, 5 January 2011

Introduction: the impact of therapeutic non-adherence

Non-adherence to treatment is a world-wide problem and the impact of poor adherence grows as the burden of chronic diseases grows world wide.
    • Adherence to long-term therapy for chronic illnesses in developed countries averages 50%.1
    • Hypertension,dyslipidaemia and diabetes mellitus:67-76% (MPR)2
    • COPD:44% (MPR)3
Therapeutic non-adherence is a major issue in health care. The consequences of non-adherence to long-term therapies: poor health outcomes and increased health care costs.1
  • Non-adherence may contribute to:

    • 48% of asthma deaths

    • 80% increase risk of death in diabetes

    • 3.8 times increased risk of death in the year following an MI 4

Increasing the effectiveness of adherence interventions may have far greater impact on the health of the population than any improvement in specific medical treatments.5

1              WHO: Adherence to long-term therapies: Evidence for action. 2003
2           Cramer JA et al.: The signifi cance of compliance and persistence in the treatment of diabetes, hypertension and dyslipidaemia: a review. Int J Clin Pract 2008;62:76–87.
3           Jung E et al.: Medication adherence and persistence in the last year of life in COPD patients. Respir Med 2009;103:525–534.
4              Elliott R: Non-adherence to medicines: not solved but solvable. J Health Serv Res Policy.2009;14: 58-61.
5           Haynes RB et al.: Interventions for helping patients follow prescriptions for medications. The Cochrane Library 2001

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