Lack of adherence to treatments is a prevalent problem, with very significant clinical and economic consequences, especially in patients with chronic diseases. In Spain, it is estimated that 50% of chronic patients do not adhere to the prescribed treatments, which can cause a significant public health problem.
On 26 November 2024, the Esteve Foundation organised the session Retos y estrategias en la adherencia a los medicamentos (Challenges and strategies in medication adherence), in which experts approached therapeutic adherence from a multidisciplinary point of view to raise awareness of this problem and provide some solutions. The event took place in the Antoni Esteve Auditorium of the Esther Koplowitz Center in Barcelona.
Watch the Session on the Foundation’s YouTube channel
Led by science journalist Michele Catanzaro, the session was coordinated by Olatz Ibarra, Head of the Hospital Pharmacy Service at Galdakao University Hospital and member of the Adherence Working Group. In his introductory speech, Ibarra highlighted the importance of establishing a culture of adherence among patients, among many other reasons, to guarantee the sustainability of the health system, specifically addressing political leaders. “In addition to taking medications, health professionals must take into account the entire emotional facet of patients,” the pharmacist also stressed.
“We have to change to a proactive model in which decision-making is joint between doctor and patient”
This was followed by Mireia Massot, Vice-President of the Spanish Society of Primary Care Pharmacists, who addressed adherence from the point of view of primary care. “Non-adherence limits the effectiveness of medical recommendations, wastes resources and makes it difficult to evaluate therapeutic results,” said Massot during his speech. For this reason, he called for a paradigm shift in the approach to adherence, from a reactive model to a proactive one in which decision-making is joint between doctor and patient.
Finally, Tomás Fajardo, presented the Platform of Patient Organizations, which gives voice to 41 organizations. During his presentation, he offered some data on chronicity in Spain, which affects 54% of the population and not necessarily the oldest. “19% of the child population has a chronic diagnosis,” he highlighted. From the patient’s point of view, he highlighted the importance of establishing training programmes in therapeutic adherence, perfecting digitalisation and also promoting shared decision-making. As for health professionals, Fajardo called for improved communication with the patient, comprehensive care and the establishment of interdisciplinary protocols.
The session, face-to-face and streamed, was held days after Medication Adherence and Information Day, on November 15, an initiative in which more than 120 hospitals remind patients of the importance of following the guidelines in their treatment and not forgetting the doses of each medication.
What is adherence?
The World Health Organization defines adherence as the degree to which a patient’s behavior, in relation to taking medication, following a diet or modifying lifestyle habits, corresponds to the recommendations agreed with the health professional. The magnitude and consequences associated with non-compliance place adherence as a major public health issue globally. In addition, the progressive increase in the number of multipathological and polymedicated patients adds to this problem.
In primary care, up to 40% of multipathological patients have three or more chronic diseases and, of these, 94% are polymedicated (5), so it is essential to follow an adequate therapeutic adherence strategy to ensure control of the disease. From the point of view of health resources, patients with chronic pathologies account for 80% of consultations in primary care centres and represent 60% of hospital stays, especially in unscheduled admissions.
KEYWORDS | Social pharmacology, therapeutic adherence
