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

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The ABC of prescribing medication

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.

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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.

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