Why do patients fail to take medicines correctly?


“More than 50% of all medicines are prescribed, dispensed or sold inappropriately, and half of all patients fail to take medicines correctly.”
WHO Fact Sheet 2012

So why do half of all patients fail to take medicines correctly?

Issues of adherence are different depending on whether the condition in acute chronic. For example, it is extremely common for patients to fail to take the complete course of antibiotics for an acute infection, thereby predisposing to antibiotic resistance. For background on adherence in relation to chronic conditions, you can freely download the WHO publication ‘Adherence to Long-term Therapies’ (1.5Mb): (Open Access)

Here are the “Take-home messages” (reproduced from the report):

1. Poor adherence to treatment of chronic diseases is a worldwide problem of striking magnitude
Adherence to long-term therapy for chronic illnesses in developed countries averages 50%. In developing countries, the rates are even lower. It is undeniable that many patients experience difficulty in following treatment recommendations.

2. The impact of poor adherence grows as the burden of chronic disease grows worldwide
Noncommunicable diseases and mental disorders, human immunodeficiency virus/acquired immunodeficiency syndrome and tuberculosis, together represented 54% of the burden of all diseases worldwide
in 2001 and will exceed 65% worldwide in 2020.The poor are disproportionately affected. The consequences of poor adherence to long-term therapies are poor health outcomes and increased health care costs

3. Poor adherence to long-term therapies severely compromises the effectiveness of treatment making this a critical issue in population health both from the perspective of quality of life and of health economics. Interventions aimed at improving adherence would provide a significant positive return on investment through primary prevention (of risk factors) and secondary prevention of adverse health outcomes.

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