Systems-based Approaches to Improving Medication Adherence

With the shift from a disease landscape that focuses on the treatment of acute and short-term illnesses to one that faces an increasing burden of chronic diseases that may require life-long medicine use, the role of medicines in ensuring a healthy population is more important than ever.

However,even when medicines are available, patients may not take them as directed. In other words, they may not adhere to the treatment prescribed to them. This problem is surprisingly widespread. Several studies have estimated that in developed countries, only approximately 50% of patients who suffer from chronic diseases take their medicines as directed.

This document suggests a health systems strengthening (HSS) approach to addressing
medication adherence issues, with a particular emphasis on its application in low- and middle-income settings. Chapter 2 reviews the importance of considering health systems in improving medication adherence and introduces a system-based framework, while Chapters 3–5 discuss approaches, interventions, and activities that span the health system as described at the
macro, meso, and micro levels and provide implementation examples.

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