One in three babies born this year will live to the age of 100!
Ageing population, NCDs & adherence to treatment. Nowdays, we differentiate elderly and extreme elderly > 80yrs. The extreme elderly is the fastest growing sector of the population. A 3-fold increase between 2000 and 2050, is estimated.
Chronic & acute, non-communicable diseases (NCDs) are on the rise, one of the reasons being, the ageing population.
NCDs, such as cardiovascular diseases, diabetes, chronic respiratory diseases & cancer, most likely, emerge in middle age and kill 38 million people, each year! NCDs are more probable after long exposure to adverse social, environmental, behavioural and lifestyle factors or exposure to common risk factors which act synergistically. NCDs are highly preventable, but, if they occur, they have low cure rate and they require long term and often, expensive treatment.
Increasing medication use with age is common to address specific symptoms, improve quality or extend quantity of life, or heal curable conditions; given the NCDs acceleration, the figures multiply.
Almost 20% of community-based elders (65 years or older) take 10 or more medications.
Boyd CM, Darer J, Boult C, Fried LP, Boult L, Wu AW. Clinical practice guidelines and quality of care for older patients with multiple comorbid diseases.
Approximately one half of elders who take at least 1 medication find adherence challenging. They may be adherent to some of their medications and non-adherent to others.
Osterberg L, Blaschke T. Adherence to medication. N Engl J Med.
Documented types of non-adherence include:
Hesitance to initiate therapy
Skipped doses and/or dose self-adjustment
Inappropriate drug administration
Medication non-adherence is considered as a significant public health issue, since it leads to poor health outcomes and increased healthcare costs.
As health care reform advances, the hope is that physicians will share medication management responsibilities following the patient-centred model of care, and thus, augment adherence levels.
Using combinations of approaches and supporting clinical intervention with adherence tools will be necessary for most patients.
Measuring and quantifying non-adherence, not only in trials but also in clinical practice, is crucial for pharmaceutical companies to get to the bottom of medication adherence and devise ways to improve it!