Medication non-adherence: reflecting on two decades since WHO adherence report and setting goals for the next twenty years.

Background: Non-adherence to medication remains a persistent and significant challenge, with profound implications for patient outcomes and the long-term sustainability of healthcare systems. Two decades ago, the World Health Organization (WHO) dedicated its seminal report to adherence to long-term therapies, catalysing notable changes that advanced both research and practice in medication adherence. The aim of this paper was to identify the most important progress made over the last 2 decades in medication adherence management and to initiate a discussion on future objectives, suggesting priority targets for the next 20 years.

Identifying and presenting key country-specific indicators related to medication adherence: a comprehensive study across European countries.

This study tackles the critical challenge of medication non-adherence in healthcare by pinpointing indicators related to medication adherence (IRMAs) across 39 European countries and Israel. Utilizing a structured expert survey methodology within the European Network to Advance Best Practices and Technology on Medication Adherence (ENABLE; COST Action CA19132), our research identified key country-specific IRMAs and collected data on these indicators to understand the multifaceted nature of medication adherence. The research was conducted in two phases: firstly, defining key IRMAs through a two-round expert survey, and secondly, gathering country-specific data on these IRMAs through literature reviews and additional expert surveys.

Adherence to the antirheumatic drugs: a systematic review and meta-analysis.

Introduction: This systematic review and meta-analysis aimed to analyze the adherence rate for conventional and biological disease-modifying antirheumatic drugs (DMARDs) utilizing different assessment measures.

Method: A systematic literature search was performed in four electronic databases, including PubMed, Scopus, Web of Science, and the Cochrane Central Register of Controlled Trials (CENTRAL), covering the time frame from April 1970 to April 2023. Studies that present data on medication adherence among adult patients with rheumatoid arthritis (RA), specifically focusing on DMARDs (conventional or biological), were included in the analysis.

Is the KOS-Zawał coordinated care program effective in reducing long-term cardiovascular risk in coronary artery disease patients in Poland? Insights from analysis of statin persistence in a nationwide cohort.

Background: The KOS-Zawał coordinated care (CC) program was introduced in response to challenges in achieving satisfactory survival rates for acute myocardial infarction (AMI) patients in Poland. This system addresses fragmented health delivery for high-risk patients. One of its principal targets is to ensure effective management of dyslipidemia, a critical aspect of secondary prevention, which is often affected by poor adherence.

Engagement of medication users in the development and implementation of digital medication adherence technologies: a multi-stakeholder study.

Background: This study aims to create a comprehensive framework for the development and implementation of digital medication adherence technologies (DMATech), focusing on critical stages where engagement of medication users (MU) is considered meaningful, i.e. adds significant value, as agreed upon by participating stakeholders.

Statins use amidst the pandemic: prescribing, dispensing, adherence, persistence, and correlation with COVID-19 statistics in nationwide real-world data from Poland.

Background: Adherence to medications presents a significant challenge in healthcare. Statins, used in primary and secondary prevention of cardiovascular disease, are of particular importance for public health. The outbreak of the COVID-19 pandemic resulted in additional healthcare system-related barriers impeding the execution of therapies.

Optimizing polypharmacy management in the elderly: a comprehensive European benchmarking survey and the development of an innovative online benchmarking application.

Polypharmacy, defined as the simultaneous use of multiple medications by a patient, is a worldwide problem of rising prevalence. Paving the way for drug interactions, adverse drug reactions and non-adherence, it leads to negative health outcomes, increased use of healthcare services and rising costs. Since it is closely related to multimorbidity, it peaks in older adults.

New terminology of medication adherence enabling and supporting activities: ENABLE terminology.

Medication non-adherence negatively affects the effectiveness of evidence-based therapies and sustainability of healthcare systems. Lack of agreed terminology of medication adherence enabling and supporting activities leads to underuse of the available tools. The ENABLE COST Action was aimed at proposing a new terminology for these activities in order to help both scientific research and its clinical application.

From non-adherence to adherence: Can innovative solutions resolve a longstanding problem?

Non-adherence to medication is a longstanding problem, profoundly affecting patient outcomes and sustainability of healthcare systems. Historically, non-adherence has been observed since the time of Hippocrates, however, when potent drugs became available in the midst of the 20th century, it became a pivotal concern. Despite numerous studies and interventions designed, medication adherence rates remain suboptimal, currently reaching about 50 % still, as described in WHO report two decades ago.

Recommendations for wider adoption of clinical pharmacy in Central and Eastern Europe in order to optimise pharmacotherapy and improve patient outcomes.

Clinical pharmacy as an area of practice, education and research started developing around the 1960s when pharmacists across the globe gradually identified the need to focus more on ensuring the appropriate use of medicines to improve patient outcomes rather than being engaged in manufacturing and supply. Since that time numerous studies have shown the positive impact of clinical pharmacy services (CPS). The need for wider adoption of CPS worldwide becomes urgent, as the global population ages, and the prevalence of polypharmacy as well as shortage of healthcare professionals is rising.

GATEKEEPER's Strategy for the Multinational Large-Scale Piloting of an eHealth Platform: Tutorial on How to Identify Relevant Settings and Use Cases.

Background: The World Health Organization's strategy toward healthy aging fosters person-centered integrated care sustained by eHealth systems. However, there is a need for standardized frameworks or platforms accommodating and interconnecting multiple of these systems while ensuring secure, relevant, fair, trust-based data sharing and use. The H2020 project GATEKEEPER aims to implement and test an open-source, European, standard-based, interoperable, and secure framework serving broad populations of aging citizens with heterogeneous health needs.

The prevalence of symptoms and its correlation with sex in polish COVID-19 adult patients: Cross-sectional online open survey.

Background: The understanding and treatment of COVID-19 has improved rapidly since December 2019 when SARS-CoV-2 was sequenced. However most papers on its symptomatology focus on hospitalized patients and address only a limited number of major presentations. Although differences depending on sex of COVID-19 patients have been previously confirmed (higher ICU admission and higher death rate for men), no publication has focused on sex-related differences in COVID-19 symptomatology.

Half a Century of Fragmented Research on Deviations from Advised Therapies: Is This a Good Time to Call for Multidisciplinary Medication Adherence Research Centres of Excellence?

Medication adherence is a key precondition of the effectiveness of evidence-based therapies. However, in real-life settings, non-adherence to medication is still very common. This leads to profound health and economic consequences at both individual and public health levels.

The impact of the war on maintenance of long-term therapies in Ukraine.

Due to the Russian invasion, which started on 24 February 2022, the Ukrainian healthcare system is facing multiple challenges. A great number of healthcare facilities have been destroyed, while availability of other ones is often limited due to a lack of qualified medical staff. Certain services, e.

Reimbursed medication adherence enhancing interventions in 12 european countries: Current state of the art and future challenges.

Medication non-adherence jeopardises the effectiveness of chronic therapies and negatively affects financial sustainability of healthcare systems. Available medication adherence-enhancing interventions (MAEIs) are utilised infrequently, and even more rarely reimbursed. The aim of this paper was to review reimbursed MAEIs across selected European countries.

Prevalence of Chronic Polypharmacy in Community-Dwelling Elderly People in Poland: Analysis of National Real-World Database Helps to Identify High Risk Group.

Multimorbidity often comes with age, making elderly people particularly prone to polypharmacy. Polypharmacy, in turn, is a risk factor for adverse drug reactions, drug-drug interactions, non-adherence to medication, negative health outcomes, and increased healthcare services utilization. The longer the exposure to polypharmacy is, the higher the risk of these consequences is.

The Potential to Reduce Patient Co-Payment and the Public Payer Spending in Poland through an Optimised Implementation of the Generic Substitution: The Win-Win Scenario Suggested by the Real-World Big Data Analysis.

High medication costs are one of the major barriers to patient adherence. Medication affordability might be improved by generic substitution. The aim of this study was to assess the effectiveness of the implementation of generic substitution mechanisms in Poland.

Lesson learned from an international training program on patients medication adherence for healthcare professionals.

Objective. Healthcare professionals play a crucial role for promoting medication adherence in older adults. This research aimed to assess changes in professionals' opinions about medication adherence after attending a course, collecting suggestions for future educational programs.

A Cross-Sectional Survey on Medication Management Practices for Noncommunicable Diseases in Europe During the Second Wave of the COVID-19 Pandemic.

Maintaining healthcare for noncommunicable diseases (NCDs) is particularly important during the COVID-19 pandemic; however, diversion of resources to acute care, and physical distancing restrictions markedly affected management of NCDs. We aimed to assess the medication management practices in place for NCDs during the second wave of the COVID-19 pandemic across European countries. In December 2020, the European Network to Advance Best practices & technoLogy on medication adherencE (ENABLE) conducted a cross-sectional, web-based survey in 38 European and one non-European countries.

Persistence as a Robust Indicator of Medication Adherence-Related Quality and Performance.

Medication adherence is a priority for health systems worldwide and is widely recognised as a key component of quality of care for disease management. Adherence-related indicators were rarely explicitly included in national health policy agendas. One barrier is the lack of standardised adherence terminology and of routine measures of adherence in clinical practice.