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