Poor adherence to long-term treatment of chronic diseases is a worldwide problem. 2003.

Based on: (1) World Health Organization. Adherence to long-term therapies. Evidence for action. Geneva: WHO; 2003. (2) World Health Organization. Failure to take prescribed medicine for chronic diseases is a massive, world-wide problem [press release]. Available from: http://www.who.int/mediacentre/releases/2003/pr54/en/. Accessed 7 September 2003. Around the world, public health efforts to deal with a wide variety of chronic conditions are being undermined by the alarmingly low adherence to therapies, according to a report recently issued by the World Health Organization. Adherence problems are found in all situations where the self-administration of treatment is required, with illnesses that include asthma, hypertension, depression, diabetes, HIV/AIDS, tuberculosis, and dependence on tobacco or other substances. In developed countries, adherence to therapies averages 50%, and the figures are much lower in less developed nations. “Poor adherence is the primary reason for not achieving the full health benefits medicines can provide to patients,” said Dr. Derek Yach, Executive Director, Noncommunicable Diseases and Mental Health, World Health Organization (WHO). “It causes medical and psychosocial complications of disease, reduces patients’ quality of life, increases the likelihood of development of drug resistance, and wastes health care resources. Taken together, these direct consequences impair the ability of health care systems around the world to achieve population health goals.” Simplistic approaches to improving the quality of life of persons with chronic conditions are not appropriate, Yach noted in the preface to the new WHO report. Instead, what is needed is a deliberative approach that reviews the way that health professionals are trained and rewarded and that systematically tackles the many barriers that patients encounter as they try to maintain optimal health.