Wednesday, June 25, 2014

What is medication adherence ?

Adherence - Wikipedia definition (summarized)

In medicine, adherence (also compliancecapacitance) describes the degree to which a patient correctly follows medical advice. Most commonly, it refers to medication or drug compliance.

Worldwide, non-adherence is a major obstacle to the effective delivery of health care. Estimates from the World Health Organization (2003) indicate that only about 50% of patients with chronic diseases living in developed countries follow treatment recommendations.[1] In particular, low rates of adherence to therapies for asthmadiabetes, and hypertension are thought to contribute substantially to the human and economic burden of those conditions.[1] Compliance rates may be overestimated in the medical literature, as compliance is often high in the setting of a formal clinical trial but drops off in a "real-world" setting.[4]

Some figures are available from the UK on non-adherence:
  • up to 90% of diabetes patients do not take their medication well enough to benefit from that medication.[citation needed]
  • 33-50% of some cancer patients take less of their anti-cancer medicine than required.[citation needed]
  • only 75% of coronary heart disease (CHD) patients take sufficient medicine for it to be effective.
  • Up to 75% of hypertensive patients do not adhere to their medicine.
  • 41-59% of mentally ill patients take their medication infrequently or not at all.[17]
  • 33% of patients with schizophrenia don’t take their medicine at all, and 33% are poorly adherent.[18]
  • Less than 27% depressed patients adhere to their medication.[19]
In the UK, it has been estimated that if CHD patients adhered to their medication, each year 40,000 – 50,000 fewer people would have a stroke and 25,000 would not have a heart attack.[citation needed]

The financial cost to the UK National Health Service (NHS), and thus to society, is also high:
  • CHD costs the NHS in excess of £2billion on medicines; 50% of which is wasted through poor understanding and poor adherence.[citation needed]
  • Economic studies consistently show that the costs incurred with poorly controlled asthma are higher than those for a well-controlled patient with the same severity of disease. For severe asthma, it has been estimated that the savings produced by optimal control would be around 45% of the total medical costs.[20]

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