Adherence to Long-Term Therapies - Evidence for Action: Section III - Disease-Specific Reviews: Chapter XI

Adherence to Long-Term Therapies - Evidence for Action
(2003; 211 pages)

Table of Contents

Preface
Acknowledgements
Scientific writers
Introduction
Take-home messages
Section I - Setting the scene
	Chapter I - Defining adherence
		1. What is adherence?
		2. The state-of-the-art measurement
		3. References
	Chapter II - The magnitude of the problem of poor adherence
		1. A worldwide problem of striking magnitude
		2. The impact of poor adherence grows as the burden of chronic diseases grows worldwide
		3. The poor are disproportionately affected
		4. References
	Chapter III - How does poor adherence affect policy-makers and health managers?
		1. Diabetes
		2. Hypertension
		3. Asthma
		4. References
Section II - Improving adherence rates: guidance for countries
	Chapter IV - Lessons learned
		1. Patients need to be supported, not blamed
		2. The consequences of poor adherence to long-term therapies are poor health outcomes and increased health care costs
		3. Improving adherence also enhances patient safety
		4. Adherence is an important modifier of health system effectiveness
		5. Improving adherence might be the best investment for tackling chronic conditions effectively
		6. Health systems must evolve to meet new challenges
		7. A multidisciplinary approach towards adherence is needed
		8. References
	Chapter V - Towards the solution
		1. Five interacting dimensions affect adherence
		2. Intervening in the five dimensions
		3. References
	Chapter VI - How can improved adherence be translated into health and economic benefits?
		1. Diabetes
		2. Hypertension
		3. Asthma
		4. References
Section III - Disease-Specific Reviews
	Chapter VII - Asthma
		1. Defining nonadherence to asthma therapy
		2. Rates of adherence to inhaled corticosteroids and other drugs for the prevention of asthma
		3. Forms of nonadherence
		4. Factors associated with adherence to asthma treatment
		5. Adherence in special populations
		6. Interventions to improve adherence to asthma therapy
		7. Discussion
		8. Conclusions
		9. References
	Chapter VIII - Cancer (Palliative care)
		1. Definitions and epidemiology of adherence
		2. Factors and interventions affecting adherence
		3. Conclusions
		4. References
	Chapter IX - Depression
		1. Research methods: measurement of adherence and sampling
		2. Rates of adherence
		3. Predictors of adherence
		4. Interventions to improve adherence
		5. Clinical implications and need for further research
		6. References
	Chapter X - Diabetes
		1. Introduction
		2. Treatment of diabetes
		3. Definition of adherence
		4. Prevalence of adherence to recommendations for diabetes treatment
		5. Correlates of adherence
		6. Interventions
		7. Methodological and conceptual issues in research on adherence to treatment for diabetes
		8. Conclusions
		9. References
	Chapter XI - Epilepsy
		1. Introduction
		2. Adherence to epilepsy therapy
		3. Epidemiology of adherence
		4. Factors affecting adherence and interventions used to improve it
		5. Conclusions
		6. References
	Chapter XII - Human immunodeficiency virus and acquired immunodeficiency syndrome
		1. Types of nonadherence
		2. Challenges in assessing adherence
		3. Predictors of adherence
		4. A framework for interventions to increase adherence
		5. Conclusions
		6. References
	Chapter XIII - Hypertension
		1. Prevalence of adherence to pharmacotherapy in patients with hypertension
		2. Impact of adherence on blood pressure control and cardiovascular outcome
		3. Adherence to non-pharmacological treatment
		4. Factors contributing to adherence
		5. Interventions for improving adherence
		6. Conclusions
		7. References
	Chapter XIV - Tobacco smoking cessation
		1. The burden of tobacco smoking
		2. Clinical guidelines and therapies available for tobacco smoking cessation
		3. Definitions
		4. Epidemiology of adherence
		5. Factors affecting adherence
		6. Interventions for improving adherence
		7. Cost, effectiveness and cost-effectiveness of adherence
		8. Conclusions
		9. References
	Chapter XV - Tuberculosis
		1. Definition of adherence
		2. Factors that influence adherence to treatment
		3. Prediction of adherence
		4. Strategies to improve adherence to treatment
		5. Questions for future research
		6. References
Annexes
	Annex I - Behavioural mechanisms explaining adherence
		1. Introduction
		2. The nature of poor adherence
		3. Determinants of adherence
		4. Models
		5. Interventions
		6. Conclusions
		7. References
	Annex II - Statements by stakeholders
		1. Family, community and patients' organizations
		2. Behavioural medicine
		3. General practitioners/family physicians
		4. Industry
		5. Nurses
		6. Pharmacists
		7. Psychologists
	Annex III - Table of reported factors by condition and dimension
	Annex IV - Table of reported interventions by condition and dimension
	Annex V - Global Adherence Interdisciplinary Network (GAIN)
		Scientists
		Professional, industry and patients' organizations
		Policy-makers
Where to find a copy of this book
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3. Epidemiology of adherence

Adherence can vary from an occasional missed dose to chronic defaulting on medication regimens (21). Adherence to antiepileptic drugs in patients with epilepsy generally ranges from 20 to 80% (12,19 - 21). Some studies reported different ranges of adherence for adult patients (40 - 60%) and children (25 - 75%) (3,12).