Adherence to Long-term Therapies: Evidence for Action
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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Page 146 - Five-year findings of the Hypertension Detection and Followup Program. I. Reduction in mortality of persons with high blood pressure, including mild hypertension.
Page 151 - Prevention of type 2 diabetes mellitus by changes in lifestyle among subjects with impaired glucose tolerance.
Page 80 - Report of the Expert Committee on the Diagnosis and Classification of Diabetes Mellitus.
Page 80 - National Diabetes Fact Sheet: National estimates and general information on diabetes in the United States. Revised edition.
Page 120 - 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 111 - 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 102 - 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 57 - ... 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...