A WHO report from Geneva has shown that Only approximately 50% of patients in developed countries are compliant and adhere to treatment in chronic diseases and this is even lower in developing countries. The compliance of patients to adhere to the long-term treatment medication of
diseases such as cardiovascular diseases, HIV/AIDS, or depression, is poor.
In the findings of the WHO's newly published report entitled "Adherence to Long-Term Therapies",it was found that in Gambia, China, and the United States only 27%, 43% and 51%, respectively, of patients adhere to their medication regimen for high blood pressure. Similar patterns have been reported for other conditions such as depression (40%-70%), asthma (43% for acute treatments and 28% for maintenance), and HIV/AIDS (37%-83%). In the United States, the United Kingdom and in Venezuela, only 30%, 7% and 4.5%, of treated patients, respectively, had good control of blood pressure. In Sudan, only 18% of non-adherent patients achieved good blood pressure control compared to 96% of those who adhered.
"Poor adherence is the primary reason for not achieving the full health benefits medicines can provide to patients. It causes medical and psychosocial complications of disease, reduces patients' quality of life, increases the likelihood of development of drug resistance and wastes health care resources," said Dr Derek Yach, Executive Director,
Noncommunicable Diseases and Mental Health, World Health Organization.
"Taken together, these direct consequences impair the ability of health care systems around the world to achieve population health goals."
The adherence problem is set to expand as the worldwide burden of chronic diseases increases. Noncommunicable diseases (e.g. cardiovascular disease, cancer, diabetes), mental health disorders, HIV/AIDS and tuberculosis combined represented 54% of the global burden of illness in
2001 and are expected to exceed 65% in 2020.
"Better adherence will not threaten health care budgets. On the contrary, adherence to those medicines already prescribed will result in a significant decrease in the overall health budget," said Dr Eduardo Sabaté, Medical Officer, WHO. "This is due to the reduction in the need for more costly interventions, such as frequent and longer hospitalizations, unnecessary use of emergency room and highly expensive intensive care services." Rational use of medicines means good prescribing and full adherence to the prescriptions.
"Health professionals witness the need for better patients' adherence to the treatments they are prescribed. Given that the health care system is partially at fault, incentives must be created to reinforce the efforts of all health professionals in favour of adherence," said Dr Rafael Bengoa, Director, Management of Noncommunicable Diseases, WHO.
What is required is a behavioural support system for the patients.This will ensure betterresource utilisation in the already stretched health systems and will improve the lives of people with chronic diseases.