From the therapeutic adherence to the therapeutic alliance: improving trust between patients and professionals to increase healthcare outcomes.

Europe and the Member States have a duty to attempt any possible solution to increase the level of adherence to treatment, in order to achieve important savings and improve the quality of life of citizens. This could be confirmed, of course, also in the next mandate of the EU Institutions. This is, in synthesis, the main message coming from the 12th edition of the European Patients’ Rights Day, held at the European Parliament in Brussels today, and organized by Active Citizenship Network, the European Branch of the Italian NGO Cittadinanzattiva.

The event was hosted by MEP David Borrelli, introduced by a video message of the European Commissioner for Health and Food Safety Andriukaitis, and realized thanks the support of: MSD, Merck, Bayer, Boehringer Ingelheim, GAfPA.

Started from concrete experiences, good practices and bad examples, the initiative provided patient associations coming form 16 different countries, health care professionals, pharmacists, industry and representatives of institution the opportunity to work together in identifying the main changes that are necessary to face non-adherence to treatment plans.

 “Improving treatments and reducing costs, thanks to an enhanced treatment adherence are our main challenges; our duty, especially for what concerns the chronicity”, said Antonio Gaudioso, secretary general of Cittadinanzattiva.

“The topic is linked to several patients' rights”, said Mariano Votta, Director of Active Citizenship Network, “the right to information, the right to preventive measures, the right to consent and the right to personalized treatment. To summarize, we can affirm that adherence to treatment is a right, in particular of the chronic patients.

General practitioners must develop a relationship with the patient based on trust and dialogue, playing a role in the education of the patient and monitoring adherence to treatment. For these reasons we would like to extend our awareness campaign that successfully launched this year in Italy, called "Cura di coppia", (couple therapy: ), involving across Europe patients’ and health professionals associations”.

The causes of lack or little adherence to treatments are different and include social and economic factors, health system and healthcare professional related factors, pathological condition, the complexity of the treatment, desease unawareness, inadequate follow up, cognitive decay, depression, lack of information regarding therapies. For these reasons, panelists agreed about the need to move from therapeutic adherence to therapeutic alliance.

Highlights: The poor adherence to treatments has significant implications: it is estimated that each year the poor adherence to medical treatments in Europe causes about 200,000 deaths and burdens on health expenditure up to 80 billion euro a year.

Proper prescription fulfill a main role to avoid the rise of negative events dued to therapeutic choices not properly focused: in Europe 40% of people aged 65 and over consume between five and nine medicines per week; this number is even higher for 18% of this population where the consumption rate can be of more than 10 medicines weekly.

According the “Action Group on Prescription and adherence to medical plans” promoted by EU Commission, adherence diminishes with an increased number of  drugs and of doses per day and the complexity of treatments: 79% of patients take their “once  a day” dose, but only 51% of those supposed to take four doses do so; among patients with  chronic illness, approximately 50% do not take medications as prescribed.

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