These are the resources and organisations that the CfBI Medical Adherence and Digital Health consortium recognises as authoritative in this space.
Publications
Adherence to long term therapies: evidence for action (Sabate, WHO 2003): 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 risk factors. These are asthma, cancer (palliative care), depression, diabetes, epilepsy, HIV/AIDS, hypertension, tobacco smoking and tuberculosis.
Intended for policy-makers, health managers, and clinical practitioners, 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.
Investing in medication adherence improves health outcomes and health system efficiency (Khan, OECD 2018): Poor adherence to medications affects approximately half of the patient population, leading to severe health complications, premature deaths, and an increased use of healthcare services. The three most prevalent chronic conditions – diabetes, hypertension, and hyperlipidaemia – stand out regarding the magnitude of avoidable health complications, mortality, and healthcare costs. There are three broad reasons behind these low rates of adherence to chronic disease medications. Firstly,the problem of poor adherence has rarely been explicitly included in national health policy agendas. Secondly, interventions tend to attribute the problem exclusively to patients, while the evidence suggests that health system characteristics – in particular the quality of patient-provider interaction, procedures for refilling prescriptions, or out-of-pocket costs – are lead drivers. Thirdly, patients with chronic conditions frequently feel left out of the decision about their therapy and are inclined to rebuff. This paper identifies enablers that are needed for improving adherence to medication at the system level.
Organisations
ESPACOMP (European Society for Adherence, Compliance, and Persistence). ESPACOMP is a non-profit association established to promote the science concerned with the quantitative assessment of what patients do with medicines they have been prescribed. Both the reasons for, and the clinical and economic consequences of, differences between caregivers’ prescriptions and patients’ execution of those prescriptions are principal topics of research with which the Society is concerned, along with facilitation of the translation of this research into information that is useful to patients, healthcare providers, healthcare policy makers, and pharmaceutical researchers.