Adherence to Long-Term Therapies - Evidence for Action
(2003; 211 pages) View the PDF document
Table of Contents
View the documentPreface
View the documentAcknowledgements
View the documentScientific writers
View the documentIntroduction
View the documentTake-home messages
Open this folder and view contentsSection I - Setting the scene
Close this folderSection II - Improving adherence rates: guidance for countries
Close this folderChapter IV - Lessons learned
View the document1. Patients need to be supported, not blamed
View the document2. The consequences of poor adherence to long-term therapies are poor health outcomes and increased health care costs
View the document3. Improving adherence also enhances patient safety
View the document4. Adherence is an important modifier of health system effectiveness
View the document5. Improving adherence might be the best investment for tackling chronic conditions effectively
View the document6. Health systems must evolve to meet new challenges
View the document7. A multidisciplinary approach towards adherence is needed
View the document8. References
Open this folder and view contentsChapter V - Towards the solution
Open this folder and view contentsChapter VI - How can improved adherence be translated into health and economic benefits?
Open this folder and view contentsSection III - Disease-Specific Reviews
Open this folder and view contentsAnnexes
Open this folder and view contentsWhere to find a copy of this book

4. Adherence is an important modifier of health system effectiveness

Health outcomes cannot be accurately assessed if they are measured predominantly by resource utilization indicators and efficacy of interventions.

The economic evaluation of nonadherence requires the identification of the associated costs and outcomes. It is logical that nonadherence entails a cost due to the occurrence of the undesired effects that the recommended regimen tries to minimize. In terms of outcomes, nonadherence results in increased clinical risk and therefore in increased morbidity and mortality.

For health professionals, policy-makers and donors, measuring the performance of their health programmes and systems using resource utilization end-points and the efficacy of interventions is easier than measuring the desired health outcomes. While such indicators are important, over-reliance on them can bias evaluation towards the process of health care provision, missing indicators of health care uptake which would make accurate estimates of health outcomes possible (64).

The population-health outcomes predicted by treatment efficacy data will not be achieved unless adherence rates are used to inform planning and project evaluation.

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