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Medical adherence, commonly known as medication compliance, refers to a patient’s ability and commitment to follow recommended treatment plans, medication guidelines and lifestyle changes as advised by their healthcare providers. While adherence seems like a simple concept, it remains one of the biggest challenges in healthcare with widespread consequences. In this article, we explore why medical adherence is so crucial yet difficult to achieve, and ways we can collectively improve adherence rates.
What is non-adherence and why does it matter?
Non-adherence refers to when patients do not follow the treatment plan or medication regimen as recommended by their doctors. This includes not taking medications as prescribed, skipping or doubling up on doses, stopping treatment prematurely and failure to adopt recommended lifestyle modifications and follow-ups. Shockingly, worldwide rates of non-adherence for long-term therapies range from 25-50%.
Non-adherence has severe clinical and economic repercussions. From a health perspective, it can lead to treatment failure, disease relapse and progression, drug resistance and even mortality in some cases. Economically, it is estimated to cost the global healthcare system over $300 billion annually. This is due to increased hospitalizations, emergency visits and prolonged illnesses resulting from non-adherent patients. Overall, non-adherence diminishes clinical effectiveness of treatments and wastes healthcare resources.
Factors affecting medical adherence
Several patient-related, condition-related, therapy-related and healthcare-related factors influence a patient’s ability and motivation to adhere.
– Patient factors: Forgetfulness, complicated regimens, lack of awareness, mental health issues, low health literacy and negative attitudes can all reduce adherence. Older age groups tend to adhere better.
– Condition factors: Asymptomatic or less noticeable diseases like hypertension are harder to adhere to compared to very symptomatic illnesses.
– Therapy factors: More complex and long-term therapies require greater discipline and adherence compared to short-term treatments. Side effects also reduce adherence.
– Healthcare factors: Poor doctor-patient communication, lack of follow-ups, financial barriers, distrust in healthcare systems and uncoordinated care negatively impact adherence levels.
Improving adherence through multi-pronged strategies
Given the widespread consequences of non-adherence, healthcare systems and policymakers need large-scale, collaborative efforts to promote adherence. Some strategies that have shown promise include:
Simplifying dosing regimens: Once-daily medications have higher adherence than multiple daily doses. Combination pills have also helped.
Educating patients: Counselling to improve awareness, highlight consequences of non-adherence and manage side-effects can boost motivation levels. Technology platforms help extend such education programs.
Improving health literacy: Simple diagrams, reminders and engaging patient education materials in local languages aid understanding and adherence, especially for older populations.
Addressing psychological barriers: Depression screening and basic counseling can help adherence in patients with mental health issues. Support groups improve motivation.
Leveraging technology and digital solutions: Adherence apps with dosage reminders and tracking functions, short educational videos, telemedicine and remote monitoring tools promote independent medication management. AI voice assistants further facilitate these technologies.
Reducing cost barriers: Government or charity programs to subsidize treatment costs can alleviate obstacles due to lack of affordability in lower income groups.
Coordinated follow-ups: Regular doctor-patient engagement through phone calls and reminders strengthen trust and accountability in sustaining treatment plans long-term. Multi-disciplinary care teams boost coherence in care.
The Path Forward
An all-inclusive approach combining education, communication, simplification of regimens, use of technology, improving health affordability, coordinated care and addressing community needs is vital to uplift adherence. Concerted collaboration between government agencies, private organizations, patient advocacy groups and healthcare providers can optimize available resources towards this critical public health goal. Only through diligent multi-dimensional efforts over time can we hope to make a significant dent in the global non-adherence challenge and improve clinical outcomes. Patients also need to play their part through commitment to following medical advice. Overall, adherence demands a balancing act between different stakeholders working in harmony.
*Note:
1. Source: Coherent Market Insights, Public sources, Desk research
2. We have leveraged AI tools to mine information and compile it
