Adherence to Medical Plans for Active and Healthy Ageing


Elísio Costa, Anna Giardini and Alessandro Monaco (Editors)
UCIBIO, REQUIMTE, Faculty of Pharmacy, Porto4Ageing Reference Site, University of Porto, Porto, Portugal

Series: Aging Issues, Health and Financial Alternatives
BISAC: HEA000000

Non-adherence to medical plans remain a challenge for health care professionals and scientists, as their efforts to improve and explain patients’ adherence appear to be ineffective. In fact, a study by the World Health Organization found that only 50% of the patients in developed countries adhere to recommended treatment plans. This degree of non-adherence results in a high number of patients that do not get the maximum benefits of medical treatment, which is associated with high health care costs, lower quality of life and poor health outcomes. A polypharmacy is often associated with inappropriate prescriptions, drug-drug and drug-disease interactions, and prescription cascade, which can all increase the risk of adverse drug reactions and therefore the discontinuation of treatment. In addition, the management of chronic diseases requires the patient’s continuous psychological adaptation and behavioral reorganization to face recurrent changes in therapeutic indications.

This book was written with the great clinical-socio-economic impact of non-adherence in global healthcare systems in mind, and the lack of advocacy both at the public and at political levels. In fact, non-adherence to medical plans is a double burden affecting the clinical outcome and consequently healthcare resources. It wastes pharmaceutical resources and prevents the correct treatment of specific conditions, leading to further medical expenditures and hospitalization associated with lower quality of life and poor health outcomes. Non-adherence to medical plans is a public health problem that affects all people in general, but with particular significance in older adults, as they show the co-occurrence of multiple chronic diseases and conditions. Many interventions to improve adherence have been described in the literature. Most interventions are associated with adherence improvements, but not with improvements in other outcomes, such as biomarkers, morbidity, mortality, quality of care, quality of life, patient’s satisfaction, health care utilization and costs. In fact, adherence rates remained unchanged over the last few decades. The reasons for the slow progress seem to be the lack of comprehensive theoretical models to explain non-adherence and to explain the potential success of a given intervention. The authors believe that in the near future, research in this area will be increased significantly, as this area is one of the priorities of the Horizon 2020 of European Commission for Research and Innovation. (Imprint: Nova)

Table of Contents

Table of Contents


Chapter 1. The ABCs of Medication Adherence
Bernard Vrijens and Przemyslaw Kardas (Department of Public Health, University of Liège, Liège, Belgium, and others)

Chapter 2. An Overview of Advanced Information Technology for Adherence in the Ageing Population with Chronic Diseases and Appropriate Polypharmacy: The Taxonomy Model
Homer Papadopoulos (Institute of Informatics and Telecommunications, National Center for Scientific Research “Demokritos”, Athens, Greece)

Chapter 3. Evidence-Based Directions for Polypharmacy Revision: The Experience Gained by the Campania Reference Site in the Framework of the EIP-AHA Action Group A1 and of the FRIENDD Pilot Study
Mauro Cataldi, Francesco Giallauria, Giuseppe Simeone, Michele Arcopinto, Vincenzo De Luca, Carmine Del Giudice, Valentina Orlando, Roberta D’Assante, Antonio Postiglione, Antonella Guida, Ugo Trama, Nicola Ferrara, Guido Iaccarino, Enrico Coscioni, Carlo Vigorito, Patrizia Cuccaro, Antonello Cittadini, Gaetano D’Onofrio, Maddalena Illario, and Enrica Menditto (Department of Neuroscience, Reproductive and Odontostomatology Sciences, Division of Pharmacology, University of Naples Federico II, Naples, Italy, and others)

Chapter 4. The Contribution of Technologies to the Adherence to Medication by Older People: A Systematic Approach
Maria José Lumini, Teresa Martins, and Maria Rui Sousa (Porto School of Nursing, Porto, Portugal)

Chapter 5. Qualitative Studies on Medication Adherence: What Do They Add to Knowledge Gained by Quantitative Methods?
Marina Maffoni and Anna Giardini (Psychology Unit, Maugeri Spa Clinical Institutes – Benefit Company, Care and Research Institute, IRCCS Montescano, Italy)

Chapter 6. Empowering Senior Citizens and Professionals to Improve Adherence to Care Plans
Giuseppe Fico and Maria Teresa Arredondo (Life Supporting Technologies, Universidad Politécnica de Madrid, Spain)

Chapter 7. Enhancing Adherence through Education
Clara Cena and Beatrice M.A. Parola (Department of Drug Science and Technology University of Turin, Turin, Italy)

Chapter 8. Enhancing Patient Adherence through Integrated Educational Programs Based on Psychological Techniques and Practices
Antonia Pierobon, Elisa Covini and Edward Callus (Psychology Unit, Maugeri Scientific Clinical Institutes, Care and Research Institute, IRCCS, Montescano, Italy, and others)

Chapter 9. Medication Adherence in the Ageing Population: The Role of Pharmacokinetics and Pharmacodyamics
Janet Mifsud (Department of Clinical Pharmacology and Therapeutics, University of Malta, Msida, Malta)

Chapter 10. Behavioral Interventions in Adherence: The Concept of Nudge
Gronchi Giorgio, Cianferotti Luisella, Parri Simone and Brandi Maria Luisa (Department of Neuroscience, Psychology, Drug Research and Child’s Health, University of Florence, Florence, Italy and others)

Chapter 11. Measuring Medication Adherence in Health-Related Databases
Enrica Menditto, Valentina Orlando, Sara Malo, Alexandra Prados-Torres and Caitriona Cahir (CIRFF, Center of Pharmacoeconomics, University of Naples Federico II, Naples, Italy, and others)

Chapter 12. The Impact of Changes in Pill Appearance on the Adherence to Medication
Elsa López-Pintor and Blanca Lumbreras (Department of Engineering, Area of Pharmacy and Pharmaceutical Technologies, Miguel Hernández University, Alicante, Spain, and others)

Chapter 13. Treatment Adherence in Patients with Rheumatoid Arthritis
Adina Turcu-Stiolica and Florin-Ananu Vreju (Department of Pharmacoeconomics, University of Medicine and Pharmacy of Craiova, Romania)

Chapter 14. Adherence to Medical Plans in End-Stage Kidney Disease Patients Under Dialysis
José S. Miranda, Verónica Poveda and Elísio Costa (Faculty of Pharmacy, University of Porto, Porto, Portugal, and others)

Chapter 15. Adherence to Topical Treatment in Psoriasis
Ana Teixeira, Maribel Teixeira, Vera Almeida, and Isabel Filipa Almeida (CESPU, Institute of Research and Advanced Training in Health Sciences and Technologies, Gandra PRD, Portugal, and others)


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