For a healthy individual, illness is something that occurs occasionally, they receive treatment, their illness is resolved, and they’re able to carry on with their lives. However, there are many conditions that, once diagnosed, will remain with someone for a considerable portion of their lives. These are known as chronic conditions and, as such, require a long-term management approach. There are different types of chronic conditions, including heart disease, diabetes, and arthritis. Cardiovascular disease (CVD) is a group of a chronic condition, requiring ongoing management in order to prevent serious complications, including stroke and heart attack. When chronic conditions are managed, individuals are able to maintain much of their lifestyle and the risk of complications are minimised.2
Understanding Chronic Conditions: Definition and Impact
A chronic condition is a long-term health challenge that may stay with someone forever, requiring continuous care and support to manage daily life. It goes without saying that a new diagnosis of a chronic disease is disruptive and life-changing. These diagnoses thrust people into a different world: a complex diagnosis must be understood, a complicated healthcare system navigated, and lifestyle and routine changed to accommodate a treatment plan. This can be especially challenging in the case of chronic conditions in the elderly, who may face multiple age-related barriers to effective disease management.
The Role of Medication in the Management of Chronic Conditions
There are a number of different approaches that can be taken to manage chronic conditions, and it is always important that patients consult their doctor to determine the best approach for them.
For some, management can include making lifestyle changes and regular monitoring, however, for many, medical intervention is required. In reality, doctors will usually recommend a combination of lifestyle changes, such as a healthy diet and physical activity, monitoring and medical intervention, especially when it comes to CVD3
Prescription Medication: Long-Term Use Is Crucial
Where health conditions require medical intervention, the medicines prescribed are generally designed to control the disease/condition rather than cure it. Therefore the medication is often designed to be taken long-term, per a doctor’s instruction.4 Adherence to the treatment plan is crucial for individuals with chronic conditions, and good adherence has been associated with higher long-term quality of life and improved outcomes.5 Despite this, approximately only 50% of individuals with chronic illnesses and prescribed long-terms medication do not take their medication as prescribed. This is particularly true for chronic conditions in older adults, who often deal with complex treatment routines.6
When Feeling Better Leads to Skipping Doses: The Paradox of Medical Adherence
When first prescribed, taking the medication is often easier. However, in many diseases, the effects of the medication may not be as apparent, seemingly maintaining symptom state rather than providing a noticeable improvement.7 At this stage, it can become more difficult to adhere to the doctor’s instructions as the symptoms may be managed and as a result, they are not felt. So, thoughts such as ‘it won’t make a difference if I miss taking my medicine today,’ ‘I’ll pick up my prescription when it’s next convenient, it won’t matter if I miss a few days’, may appear and lead to decrease in adherence.
One way to think about chronic conditions and the medications used to treat them, is to consider the condition as a bucket of water with a crack in it, and the medication as a sticking plaster that seals the crack. The sticking plaster needs to be applied every week, otherwise the bucket will leak (symptoms). At first, using the sticking plaster may make a noticeable difference, it may stop the leak. Over time, the effects of the sticking plaster become less apparent; the bucket hasn’t leaked in a while and the water level isn’t changing. However, if the plaster isn’t changed as prescribed, it will result in the crack becoming uncovered and the water will start to leak again.
Better Health Outcomes Through Collaboration
Together, patients, healthcare providers, and those associated with healthcare systems can thrive to improve medication adherence. Improving education and championing patient empowerment will help introduce joint decision making and close work with health care professionals.8 This open dialogue can be the foundation of a good relationship between the healthcare provider and patient, taking into account the individual’s lifestyle to better understand which treatment option is going to work best and make treatment adherence as easy as possible.8 Concepts such as collaborative care and shared responsibility between stakeholders have already shown positive effects in cardiovascular disease management.
Digital Tools to Support Medication Adherence
In recent years, digital health technologies have emerged as promising tools to support medication adherence. Mobile apps, smart pill dispensers and digital reminders can help patients track their treatment, set alerts and even connect with caregivers or pharmacists.
These technologies have shown measurable effects: for example, a study found that the use of mobile medication reminder apps significantly improved adherence in patients with chronic conditions.9 Such tools can be particularly valuable for patients managing complex medication regimens, or for those who feel better and are at risk of forgetting their routine.
Daiichi Sankyo, and the wider pharmaceutical industry, also have a role to play in ensuring medications are accessible and available for everyone, ensuring medication adherence is not taken out of the hands of patients. Daiichi Sankyo does everything possible to be a trusted partner to those with CVD. Our factory in Pfaffenhofen, Germany, is centrally located within Europe, answers to the highest quality standards, and aspires to ensure a stable supply of quality medications that can meet increasing patient demands now, and in the years to come.
