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

5. Improving adherence might be the best investment for tackling chronic conditions effectively

Studies consistently find significant cost-savings and increases in the effectiveness of health interventions that are attributable to low-cost interventions for improving adherence. In many cases investments in improving adherence are fully repaid with savings in health care utilization (33) and, in other instances, the improvement in health outcomes fully justifies the investment. The time is ripe for large-scale, multidisciplinary field studies aimed at testing behaviourally sound, multi-focal interventions, across diseases and in different service-delivery environments.

Interventions for removing barriers to adherence must become a central component of efforts to improve population health worldwide. Decision-makers need not be concerned that an undesired increase in health budget will occur due to increasing consumption of medications, because adherence to those medicines already prescribed will result in a significant decrease in the overall health budget due to the reduction in the need for other more costly interventions. Rational use of medicines means good prescribing and full adherence to the prescriptions.

Interventions that promote adherence can help close the gap between the clinical efficacy of interventions and their effectiveness when used in the field, and thus increase the overall effectiveness and efficiency of the health system.

For outcomes to be improved, changes to health policy and health systems are essential. Effective treatment for chronic conditions requires a transfer of health care away from a system that is focused on episodic care in response to acute illness towards a system that is proactive and emphasizes health throughout a lifetime.

Without a system that addresses the determinants of adherence, advances in biomedical technology will fail to realize their potential to reduce the burden of chronic illness. Access to medications is necessary, but insufficient in itself to solve the problem (12).

Increasing the effectiveness of adherence interventions might have a far greater impact on the health of the population than any improvement in specific medical treatments (65).

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