Chronic conditions – Why is medication adherence so important?

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. Cardiovascular disease (CVD) is an example of a chronic condition, requiring ongoing management in order to prevent more serious complications, including stroke and heart attack. When chronic conditions are managed, including CVD, individuals are able to maintain much of their lifestyle and the risk of complications are minimised.2

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.

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, monitoring and medical intervention, especially when it comes to CVD.3

Where chronic 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.6

When first prescribed, taking the medication is often easier and many will experience an immediate improvement in their symptoms. As time progresses however, 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 the person is feeling better – ‘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’.

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 will make a noticeable difference, it will 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.

Together, patients, healthcare providers, and those associated with healthcare systems can go far towards improving 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

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.

References
[1]

Gikunda, C. et al. Patient and Health System Related Factors Associated with Non-Adherence to Antihyperintensive Medication among Patients at Chuka Referral Hospital, Kenya. Open Journal of Clinical Diagnostics. 2021. 11: 19–46

[2]
World Health Organization. Adherence to long-term therapies: Evidence for action.
Available at:
Last Accessed January 2024.
[3]
Healthdirect. Management of chronic conditions.
Available at:
Last Accessed January 2024.
[4]
Center for Managing Chronic Disease – University of Michigan,
About Chronic Disease.
Available at:
Last Accessed January 2024.
[5]
Center for Disease Control and Prevention. Overcoming Barriers to Medication Adherence for Chronic Diseases.
Available at:
Last Accessed January 2024.
[6]
CPME. ”Improving the sustainability of healthcare systems through better adherence to therapies: a multi-stakeholder approach”.
Available at:
Last Accessed January 2024.
[7]

Baryakova, T.H., et al. Overcoming barriers to patient adherence: the case for developing innovative drug delivery systems. Nature Reviews Drug Discovery. 2023. 22: 387–409

[8]
Mayo Clinic Proceedings. Medication adherence: WHO cares?
Available at:
Last Accessed January 2024.