Patient non-compliance with therapeutic recommendations is one of the greatest challenges in healthcare. As many as 200,000 people die in Europe every year because of this, experts warned last week.
The Polish Society of Hypertension issued an appeal during a press conference in Warsaw to support activities to improve compliance with treatment recommendations. This applies not only to medications for hypertension and cardiovascular diseases, but many other chronic diseases as well, including diabetes.
As emphasised, every second patient with a chronic disease fails to follow the recommendations for taking medications, as well as changing lifestyle or regular check-ups. The result is a deterioration of patients' health, a higher risk of hospitalisation and premature deaths due to heart attacks and strokes, and a significant burden on the healthcare system.
'Analysis of data from Poland shows that 58 percent patients with hypertension do not follow treatment recommendations one year after diagnosis', said Professor Aleksander Prejbisz from the National Institute of Cardiology in Warsaw. Even patients who have suffered a heart attack do not follow them: after one year, as many as 70% of them stop taking drugs from the three main therapeutic classes, the expert added. These patients are much more exposed to another heart attack, this time possibly a fatal one.
The expert warns that failure to follow treatment recommendations shortens life expectancy and significantly reduces its quality. According to data presented during the press conference, the risk of death is 30% higher in patients who did not follow the recommendations compared to those who did.
Many patients do not buy their medicines at all. According to the National Health Fund, in the years 2013-2018, as many as 24% of patients with newly detected hypertension did not fill their first prescription for reimbursed medicines.
Every second hospital stay due to circulatory system diseases is related to failure to follow medical recommendations. In the case of patients with diabetes and hypertension, the risk of hospitalisation increases by 17 percent, and the number of calls for emergency medical services increases by 10 percent.
The costs of this are enormous for both patients and the healthcare system. 'In the European Union alone, annual losses due to non-compliance with therapeutic recommendations are estimated at EUR 125 billion, and in Poland at approximately PLN 6 billion', argued Professor Piotr Dobrowolski from the National Institute of Cardiology in Warsaw.
'We address our appeal to representatives of institutions responsible for shaping health policy in Poland, to patient organizations (...), to scientific societies and medical and pharmaceutical professionals (...) and to all people aware of the importance of following therapeutic recommendations for the health of Poles and the effectiveness of the healthcare system', the experts state in the document.
According to Professor Agnieszka Kapłon-Cieślicka from the 1st Chair and Department of Cardiology at the Medical University of Warsaw, increasing patients' therapeutic persistence requires a comprehensive approach, as well as systemic support. 'Education and building an effective doctor-patient relationship are important', she noted. In her opinion, it is crucial to simplify and personalise therapeutic regimens, which is facilitated by the use of long-acting drugs or combination therapy.
Single pill combinations (so-called polypills) containing two or three drugs from the same therapeutic group in one tablet are helpful. So are hybrid drugs, which combine active substances with different effects, for example hypertension drugs with statins (which lower blood cholesterol levels). Such preparations are available in Poland, they contain, for example, acetylsalicylic acid with a beta-blocker, or are a combination of antihypertensive drugs with a statin.
According to experts, improving compliance with medical recommendations is possible. 'Poland can draw on the good practices of European countries such as Portugal and Slovakia', said Professor Aleksander Prejbisz. However, taking many different types of even minor steps that, combnined, increase the chances of success, is of key importance.
'We already know how to do it, it is time for specific actions. However, it is important to unite different environments and translate scientific recommendations into specific, implementable system-wide strategies', said Jacek Wolf, PhD, from the Department of Hypertension & Diabetology at the Medical University of Gdańsk, former president of the Polish Society of Hypertension. (PAP)
Zbigniew Wojtasiński
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