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
Open this folder and view contentsSection II - Improving adherence rates: guidance for countries
Close this folderSection III - Disease-Specific Reviews
Open this folder and view contentsChapter VII - Asthma
Open this folder and view contentsChapter VIII - Cancer (Palliative care)
Open this folder and view contentsChapter IX - Depression
Open this folder and view contentsChapter X - Diabetes
Open this folder and view contentsChapter XI - Epilepsy
Open this folder and view contentsChapter XII - Human immunodeficiency virus and acquired immunodeficiency syndrome
Open this folder and view contentsChapter XIII - Hypertension
Close this folderChapter XIV - Tobacco smoking cessation
View the document1. The burden of tobacco smoking
View the document2. Clinical guidelines and therapies available for tobacco smoking cessation
View the document3. Definitions
View the document4. Epidemiology of adherence
View the document5. Factors affecting adherence
View the document6. Interventions for improving adherence
View the document7. Cost, effectiveness and cost-effectiveness of adherence
View the document8. Conclusions
View the document9. References
Open this folder and view contentsChapter XV - Tuberculosis
Open this folder and view contentsAnnexes
Open this folder and view contentsWhere to find a copy of this book
 

4. Epidemiology of adherence

The prevalence of adherence to smoking cessation therapy varied widely between studies (5 - 96%) and also varied between countries as shown in Table 8.

Table 8 Rates of adherence to smoking cessation therapy reported by country

Country

No. of values reported

Mean

Standard deviation

Minimum

Maximum

Australia

8

0.57

0.25

0.19

0.83

Denmark

23

0.59

0.14

0.33

0.86

Italy

1

0.34

-

0.34

0.34

New Zealand

4

0.86

0.16

0.63

0.96

Switzerland

2

0.53

0.10

0.46

0.60

United Kingdom

11

0.62

0.17

0.40

0.91

United States

31

0.52

0.23

0.05

0.96

This variation can be explained by the use of different interventions, adjunctive support and populations studied.

Figure 4 includes only studies that reported time-series data. It suggests that adherence to smoking cessation therapies is a logarithmic function of number of weeks. The suggested trend line shows a rapid decrease in adherence rates during the first 6 weeks and a very slow decrease after 24 weeks. (Adherence rates after week 20 are related to adherence to follow-up visits rather than therapy.)

Many studies have found a positive linear correlation between adherence and cessation rates (3,7,12,14,15,20,24,25,31 - 33,36,37,39,44). Both adherence and smoking cessation rates increased significantly when NRT was combined with antidepressant pharmacotherapy (3).


Figure 4 Adherence rates over time

NRT, nicotine replacement therapy.

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