Non-adherence to medicine can best be addressed by empowering doctors to help people: Dr. Parag Sheth, Abbott India

Shahid Akhter, editor, ETHealthworld , spoke to Dr. Parag Sheth, Regional Director, Medical Affairs, Abbott India, to figure out the impact of poor adherence to medicine and the way forward.

Poor medicine adherence: Challenges and impact

Poor adherence to medicine is a key health issue worldwide. Nearly 50% of people don’t take their medicines as prescribed; about one-third never fill their first prescription, and an estimated 31% stop taking their medicine earlier than recommended.

A study at Kempe Gowda Institute of Medical Sciences and Research Centre, Bangalore, showed that non-adherence was observed in 49.67% of patients. The problem is prevalent across therapy areas. Another Indian study suggested that nearly 76.6% of people living with diabetes showed uncontrolled blood sugar levels. This is especially concerning, given that approximately 77 million people live with diabetes in the country.

The challenge of non-adherence has far-reaching and significant social and economic impacts. For cardiovascular diseases and hypertension, for instance, non-adherence increases the risk of hospital visits and recurrent cardiac events and leads to delays in recovery. Also, the economic impact is significant: non-adherence adds up to $100 billion in preventable medical costs per year, and there are additional productivity costs associated with it. Further, roughly 8% of the total global health expenditure could be avoided with proper adherence to medicine

What are the key factors that drive non-adherence?

Poor or non-adherence to medicine is a complex, multidimensional challenge. It is driven by various factors, including a lack of patient awareness, socio-cultural beliefs, treatment fatigue, illness-related factors, and economic, logistical, and systemic causes.

These barriers include inadequate knowledge about therapy or the disease, communication challenges between healthcare professionals and patients, and limited time in primary care consultations. Other factors include fear of side effects or a cultural emphasis on disease self-management. The lack of visible immediate benefits of long-term treatments, or complex dosing regimens, are additional barriers to non-adherence.

We must also look at specific factors related to a lack of access to healthcare and the urban-rural divide in healthcare services across specific regions. Global and regional factors of non-adherence must be identified and addressed to bridge this gap, improve adherence and promote better health outcomes.

Patient adherence: Way forward

According to the World Health Organization, increasing the effectiveness of adherence interventions could have a far greater impact on the health of the population than any improvement in specific medical treatments. While taking a medicine – following diagnosis and a doctor consultation – is a vital step on the road to better health, many people do not take medicines as prescribed. This is a pressing issue to solve, as adherence can improve the health of the population at large. Thus, we must focus on driving medicine adherence, across therapy areas and regions, in India and globally.

Non-adherence is a global health challenge that requires tangible, tailored, and large-scale solutions. To address non-adherence, we must promote multi-stakeholder approaches and work together to share best practices and identify commonalities between non-adherence cases. Only through strong collaboration can we tackle the challenge, one step at a time, and establish adherence as a public health priority.

Broadly, a paradigm shift is needed – where we adopt more patient-centric, personalized approaches to care. This encourages practitioners to understand the specific patient’s motivations, beliefs, and experiences that play a role in their disease management. Behavioural science plays an important role here, understanding the factors that result in non-adherence behaviours and empowering doctors to help people take control of their health.

What is Abbott doing to support healthcare practitioners and improve medicine adherence?

At Abbott we are working on innovative approaches beyond medicines by focusing on increasing access and improving adherence to medicines. Working across our business and in partnership with others, we aim to expand access to care and remove barriers, including adherence, that prevents people from living healthy lives, wherever they are.

Abbott is partnering with leading voices in the behavioural science and medical community worldwide to redefine how healthcare professionals and patients interact, with the aim to shift the thinking from how to treat diseases to how to treat people. a:care is Abbott’s pioneering program, based on the latest research, to educate healthcare professionals and empower patients to improve adherence to their treatment. With this unique and holistic approach, a:care provides accessible resources and tools, guided by technology and behavioural science principles, to empower doctors and support people to build small, manageable steps toward better health. These tools include websites, training, and masterclasses on adherence management, as well as digital assessment solutions for healthcare professionals to help them identify specific patients' needs to better adhere to treatment and offer tailored individualized support.

As part of our continued educational efforts, we organized the first global Congress on adherence and behavioural science in 2021. The 2021 event garnered a strong reception from members of the community, receiving attention from more than 25,000 healthcare professionals globally. 10,000 practitioners also participated in the live sessions. Additionally, Abbott has held masterclasses to equip approximately 45,000 healthcare professionals with tools to improve medication adherence.

With its a:care Congress 2022 which took place virtually on October 8th?and 15th?2022, Abbott has taken a step further to sustain critical conversations on cracking the code of medicine adherence, building on the success of its event in 2021. The 2022 Congress expanded the platform’s reach to include regional satellite meetings, led by local chairs – including in India, Asia-Pacific, Latin America, Brazil, and the Middle East – thus going further to reveal hidden factors that cause challenges with adherence while providing practical, tangible solutions to improve adherence in clinical settings. Shedding light on India’s perspective of this complex problem, for instance, Dr. Shashank Joshi, Endocrinologist, Diabetologist, and member of Maharashtra’s COVID-19 task force, led a session on the challenges, myths, and realities of non-adherence in the country as part of the India satellite meeting. Experts from the regional meetings also joined the global session to discuss core issues and solutions to address non-adherence.