Adherence to Long-term Therapies: Evidence for ActionEduardo Sabaté, World Health Organization Adherence to therapies is a primary determinant of treatment success. Poor adherence attenuates optimum clinical benefits and therefore reduces the overall effectiveness of health systems. Medicines will not work if you do not take them. Medicines will not be effective if patients do not follow prescribed treatment - yet in developed countries only 50% of patients who suffer from chronic diseases adhere to treatment recommendations. In developing countries, when taken together with poor access to health care, lack of appropriate diagnosis, and limited access to medicines, poor adherence is threatening to render futile any effort to tackle chronic conditions such as diabetes, depression and HIV/AIDS. This report is based on an exhaustive review of the published literature on the definitions, measurements, epidemiology, economics, and interventions applied to nine chronic conditions and their risk factors. These are: asthma, cancer (palliative care), depression, diabetes, epilepsy, HIV/AIDS, hypertension, tobacco smoking, and tuberculosis. Intended for clinical practitioners, health managers and policy-makers, this report provides a concise summary of the consequences of poor adherence for health and economics. It also discusses the options available for improving adherence, and demonstrates the potential impact on desired health outcomes and health care budgets. It is hoped that this report will lead to new thinking on policy development, and action on adherence to long-term therapies. |
Other editions - View all
Common terms and phrases
adherence behaviour adherence rates adherence to medication adherence to treatment adolescents adults American Journal American Medical Association antidepressant antihypertensive antiretroviral therapy assessment asthma Biblioteca Bibliothèque blood pressure BRAZIL the Federative British Medical Journal CHINA the People's chronic diseases costs depression developing countries diabetes mellitus doses drug effect on adherence ence epilepsy Factors affecting adherence Facultad de Medicina Federative Republic HAART health care health care providers health professionals health system Hospital hypertension improve adherence INDIA the Republic insulin Internal Medicine Interventions to improve Medical College Medical Library ment MEXICO The United monitoring National nicotine nicotine patch nonadherence Nursing outcomes palliative care patient adherence patient education Patient-related factors People's Republic physical activity physician poor adherence prescribed programmes Psychology relationship reported Research risk Sciences self-management side-effects smoking cessation social support strategies tion tuberculosis type 2 diabetes United Mexican Universidad University WHO-HQ World Health Organization
Popular passages
Page 144 - Five-year findings of the Hypertension Detection and Followup Program. I. Reduction in mortality of persons with high blood pressure, including mild hypertension.
Page 78 - The Diabetes Control and Complications Trial Research Group. The effect of intensive treatment of diabetes on the development and progression of long-term complications in insulin-dependent diabetes mellitus.
Page 149 - Prevention of type 2 diabetes mellitus by changes in lifestyle among subjects with impaired glucose tolerance.
Page 78 - Report of the Expert Committee on the Diagnosis and Classification of Diabetes Mellitus.
Page 78 - National Diabetes Fact Sheet: National estimates and general information on diabetes in the United States. Revised edition.
Page 118 - Anthonisen NR, Connett JE, Kiley JP, et al.: Effects of smoking intervention and the use of an inhaled anticholinergic bronchodilator on the rate of decline of FEV1: the Lung Health Study.
Page 109 - Burt VL, Whelton P, Roccella EJ, et al. Prevalence of hypertension in the US adult population. Results from the Third National Health and Nutrition Examination Survey, 1988-1991.
Page 100 - A controlled trial of two nucleoside analogues plus indinavir in persons with human immunodeficiency virus infection and CD4 cell counts of 200 per cubic millimeter or less.
Page 4 - comprises all impairments or deviations from normal which have one or more of the following characteristics: are permanent; leave residual disability; are caused by nonreversible pathological alteration; require special training of the patient for rehabilitation; may be expected to require a long period of supervision, observation, or care.
Page 55 - ... integrates the psychological and spiritual aspects of patient care; offers a support system to help patients live as actively as possible until death; offers a support system to help the family cope during the patient's illness and in their own bereavement...