ABC

"Ascertaining Barriers for Compliance: policies for safe, effective and cost-effective use of medicines in Europe"

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 Obiettivo del progetto (Objective)

'Medication non-compliance is highly prevalent across all medical conditions, and represents a major barrier for realising the benefits of evidence-based therapies. The aim of the project is to produce evidence-based policy recommendations for improving patient compliance and subsequent better use of medicines by Europeans. Lack of consensus in the terminology used in this field impedes benchmarking of compliance-enhancing interventions. Therefore the first stage of the project will be to build a pan-European consensus on terminology and taxonomy of non-compliance. Effective interventions in this field should take into account the differences that exist between determinants of compliance with short-term and chronic treatments, and for different clinical sectors, health care settings and population segments. Therefore, not only will the determinants of patient compliance be identified in a systematic review of the literature, but also a survey across 16 European countries, and discrete choice experiment will be conducted. Then, a conceptual framework for the influential factors of non-compliance will be developed. Current practices of compliance management by healthcare professionals and the pharmaceutical industry will be compared across Europe, as well as educational programs from schools of medicine and pharmacy. Compliance-enhancing interventions will be compared in terms of practicality, clinical- and cost-effectiveness. The information gathered will be integrated, and priorities made to inform policy recommendations on strategies to improve patient compliance. The project findings will be discussed extensively with European experts, and based to the consensus obtained, the final recommendations will be formulated and presented to the European Commission and other relevant stakeholders. To enable widespread dissemination of the project results, they will be made available to the public as conference presentations, scientific publications and Web material.'

Introduzione (Teaser)

Medicine is an important component of health care, but can be a bitter pill to swallow for patients. Since as many as half of European patients do not take medication as prescribed, an EU-backed project identified ways to improve compliance.

Descrizione progetto (Article)

Medication is at the heart of modern medicine. It not only saves lives, but also improves the quality of life and health of patients. For medicines to be effective they must be taken as prescribed. However, up to half of European patients reportedly do not adhere to their doctors' orders, resulting in non-response to therapy, the progression of diseases, and a greater economic burden on patients, their families and society.

ABC was an EU-financed project set up to provide empirical evidence on how to enhance patient adherence and improve the use of medication in Europe. Targeting different clinical sectors, health care settings and population groups, the project identified the determinants of non-compliance and investigated current adherence management practices. ABC members also assessed the effectiveness of various interventions and produced policy recommendations for health care professionals, policymakers, patients, industry and the research community.

Of 771 individual non-compliance factors identified by ABC, the majority were related to implementation, with only 47 relating to persistence with medication. This means that measures to improve implementation could have an enormous impact.

Therefore, the project concluded that patients need to be empowered and supported with information and education when medication is first prescribed. Health care professionals also need more education and training on patient-centred care, identifying and addressing non-adherence, and choosing the right intervention.

To achieve this, ABC recommends the two parties should discuss the patient's treatment beliefs and preferences, forge a partnership to make decisions on treatment, and build up mutual trust.

Moreover, where possible, industry should simplify medication regimens, while health care providers should prioritise adherence support. In addition, governments should raise public awareness, promote effective interventions and support further research in the field.

The project's integrated set of recommendations could make adherence as simple as ABC, with huge benefits for patients, their loved ones and society.