Half a Century of Fragmented Research on Deviations from Advised Therapies: Is This a Good Time to Call for Multidisciplinary Medication Adherence Research Centres of Excellence?

Abstract

Medication adherence is a key precondition of the effectiveness of evidence-based therapies. However, in real-life settings, non-adherence to medication is still very common. This leads to profound health and economic consequences at both individual and public health levels. The problem of non-adherence has been extensively studied in the last 50 years. Unfortunately, with more than 130,000 scientific papers published on that subject so far, we are still far from finding an ultimate solution. This is, at least partly, due to fragmented and poor-quality research that has been conducted in this field sometimes. To overcome this deadlock, there is a need to stimulate the adoption of best practices in medication adherence-related research in a systematic way. Therefore, herein we propose the establishment of dedicated medication adherence research Centres of Excellence (CoEs). These Centres could not only conduct research but could also create a profound societal impact, directly serving the needs of patients, healthcare providers, systems and economies. Additionally, they could play a role as local advocates for good practices and education. In this paper, we propose some practical steps that might be taken in order to establish such CoEs. We describe two success stories, i.e., Dutch and Polish Medication Adherence Research CoEs. The COST Action “European Network to Advance Best practices & technoLogy on medication adherencE” (ENABLE) aims to develop a detailed definition of the Medication Adherence Research CoE in the form of a list of minimal requirements regarding their objectives, structure and activities. We hope that it will help to create a critical mass and catalyse the setup of regional and national Medication Adherence Research CoEs in the near future. This, in turn, may not only increase the quality of the research but also raise the awareness of non-adherence and promote the adoption of the best medication adherence-enhancing interventions.

Digital Pharmacotherapy Support for Medication Adherence

“…Цифровое здравоохранение является относительно новым и активно развивающимся 4 https://bradex.ru/category/konteynery-dlya-tabletok 5 https://www.techenhancedlife.com/reviews/gms-automatic-pill-dispenser направлением [40]. В настоящее время формируется база электронных технологий, позволяющих обеспечить соблюдение режима приема ЛП пациентами, минимизировав при этом участие медицинских работников [40,41]. Определяющим фактором при создании электронных сервисов является удобство в использовании и легкость интеграции в повседневную жизнь пациента [42].…”

New terminology of medication adherence enabling and supporting activities: ENABLE terminology

“…For these reasons, the problem of non-adherence has been extensively studied for the last 50 years. Unfortunately, despite the number of scientific papers published on that subject grossly exceeding 100,000, we are still far from finding an ultimate solution ( Kardas et al, 2023 ). In real-life settings, non-adherence to medication is still highly prevalent.…”

Current Obstacles (With Solutions) in Type 2 Diabetes Management, Alongside Future Directions

“…Another issue that should be taken into account is the individualization of therapeutic approaches (bearing in mind the effectiveness, risk of hypoglycemia, potential cardiometabolic and renal benefits, comorbidities, safety profile, and pharmacoeconomics) by delineating subgroups of type 2 diabetes that would benefit the most (e.g., phenotype-approach, precision medicine principles, etc. ), as well as considering factors of medication adherence (e.g., education and digital solutions) and timing (e.g., a question on using metformin, GLP-1 RA and/or SGLT-2i in prediabetes) [7][8][9][10][11][12][13][14]. In addition to standard dietary and physical activity and pharmacological interventions, (co)management approaches such as metabolic surgery and gut microbiome modification/fecal transplantation may become more important in the years yet to come, and may even potentially help us as clinicians to achieve T2D remission (as an ultimate goal) in some of our patient candidates [15][16][17].…”