Poor adherence to prescribed medication is the main reason pharmacological treatments can be ineffective and represents a threat for both patients and the healthcare system in that it creates an increased number of interventions. New strategies, in particular Patient Support Programs (PSPs), have proven effective in improving adherence to treatment.
Major causes. Seniors are at greater risk.
‘Adherence to treatment’ refers to the patient’s capacity to fully and accurately follow through treatment as prescribed by physicians (i.e. correct times, doses and frequency of administration). Patients fail to adhere to treatment for a variety of complex reasons, especially due to:
- lack of clear communication between health professionals and patients
- lack of periodical check-ups
- cognitive impairment (typical in the elderly)
- young age
- complexity of treatment
- lack of knowledge as to why treatment has been prescribed
- lack of information about treatment
- unawareness of disease
- inadequate follow-up
- social-economic factors
These causes put the senior population at a greater risk for non-adherence to treatment. According to the Italian National Institute for Statistics (Istat), Italy ranks number two in Europe in the old-age index. Considering approximately 4 out of 10 patients are chronic and almost always senior, we can see how this presents a problem. The top three chronic diseases are high blood pressure, arthritis/arthrosis and allergies.
The best and worst strategies in the process of improvement.
Cochrane, an international non-profit organization, analized the effects of interventions carried out in ambulatory settings to improve adherence to treatment. Overall, the results of the study suggest a variety of possible alternatives to optimize the use of medication, even if one effective alternative for every pathology or context does not exist.
Strategies proven to be the most successful include self-monitoring and self-management programs, more simple and reduced dosages as well as the direct involvement of pharmacists in prescription management. Other strategies, such as economic incentives, practical instruments such as reminder packaging, instructions and information combined with other strategies (i.e. self-management training and consultations) can have positive results even though supporting data is less consistent. The new trend, however, is in Patient Support Programs.
Patient Support Programs: a promising turning point.
Patient Support Programs are making a conscious contribution to improving patient adherence to treatment. These programs create a system of services to make the physician-patient-treatment relationship more effective and include house calls, direct and online psychological support, telematic services, etc. and aim at placing patients at the center, making them feel understood and valued through adequate follow-up in all stages of the disease. Consequently, adherence to treatment and the quality of the patient’s life is improved. PSP services have been developed all over the world in the last decade and are present in Italy as well. For more than ten years Domedica has been creating and managing Patient Support Programs to aid physicians, clinics and other healthcare stakeholders, contributing every step of the way to improve adherence to treatment.
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