Adherence to Long-term Therapies: Evidence for ActionEduardo Sabaté, World Health Organization World Health Organization, 2003 - 198 pages 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. |
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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
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