Breathe
By Juana Ramírez
A typical situation that many of us have gone through: a person with a disabling symptom such as acute pain that does not allow him/her to function normally, fever, nausea, dizziness, vomiting or diarrhea... here the common action is to seek medical assistance with the expectation of receiving the prescription of medicines that can eliminate the discomfort in the shortest possible time. In these cases we usually follow the doctor's indications but only until we feel better. After that, most will abandon the treatment, even if the doctor has indicated to finish the dosage even in the absence of symptoms.
How many of us actually complete pharmaceutical treatments and follow medical indications rigorously? Very few, I am afraid.
The World Health Organization estimates that less than 50% of patients have therapeutic adherence to medications, in other words, less than half of the patients follow their physicians' indications for the care or control of their conditions. And this occurs in developed countries, where the barriers to access to medicines are considerably lower than in developing countries, where it is estimated that only 30% of patients have correct adherence to their treatments.
And if when we have bothersome symptoms we abandon medicines regardless of the fact that the problem recurs - as is often the case with poorly treated respiratory diseases - the picture is even more complex when we are not dealing with these acute conditions, which have a "beginning and an end", but with chronic diseases that have no cure and which are not "felt" either. In these cases, patients often abandon treatment and return when things get complicated again.
A study published in the Journal of the American Medical Association found that only 30-50% of patients with chronic diseases comply adequately with their treatments. A common example: although the consequence of discontinuing statins in patients with hypercholesterolemia can be a heart attack or even death, it is quite common for patients to stop taking their pills when they perceive no apparent benefit. When it comes to chronic degenerative diseases such as diabetes or hypertension, in addition to the lack of discipline to follow medical indications, there is the learned hopelessness of knowing that the disease will not go away, without considering that the absence of treatment can accelerate the progression of the condition and the appearance of complications.
Although adherence to antibiotics or analgesics is relatively higher when perceiving the impact of the medicine because the patient comes from feeling very ill, also in these cases approximately 50% of patients do not complete the full course of antibiotics prescribed by their physicians and this is largely responsible for the high bacterial resistance and recurrence of infections. In a study published in the journal BMC Public Health, it is estimated that adherence to antibiotics varies between 30% and 70%, depending on the type of infection and the patient. Another report from the World Health Organization (WHO) notes that adherence to antibiotics is particularly low in the treatment of chronic infections such as tuberculosis, with adherence rates that can be less than 50%.
In general, adherence to medications depends greatly on the disease: the more severe and symptomatic it is, the greater the tendency for greater adherence. The more asymptomatic or longer term, the less adherence. The causes of this global phenomenon are multiple: from the socioeconomic ones involving costs and accessibility, those related to the treatment, such as dosage, route of administration and side effects, those related to the patient, his understanding of the disease and his support network, and the quality of medical care.
More than a matter of discipline and self-care, the consequences of non-adherence are a serious public health problem that translates into therapeutic failure, low rates of control and improvement of chronic diseases, loss of life, and overcosts in medical care. Scientific advances in disease control and care are of no use, nor are the efforts of governments around the world to improve access to medicines, if patients do not follow the indications for treatment.
Think for a moment, how many medicines end up in the trash after being in a drawer or drawer until they expire? At a forum on the subject held in Spain, one of the health systems with the best access to treatment, in 2008, 30% of the medicines deposited in SIGRE - the country's medicine collection system - were even unopened.
Patient education should be an integral part of healthcare services. There is sufficient evidence on the benefits of therapeutic adherence both for patients and for the optimization of health budgets. At the same Forum, a study was presented on patients with ulcerative colitis in which it was found that those who followed treatment according to medical indications, hospitalization costs decreased by 62%, there were 13% fewer outpatient visits and 45% fewer emergency room admissions, and healthcare costs were reduced by half. The trends are similar in studies of patients with diabetes, osteoporosis or hypertension, in which adherence not only reduces care costs, but more importantly, significantly reduces complications and premature deaths related to these diseases.
The next time you take medication, please follow the recommendations of your doctors. First for your health, but also for those who, even if they want to, still do not have access to medicines.
The opinions expressed are the responsibility of the authors and are absolutely independent of the position and editorial line of the company. Opinion 51.
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