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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