Health systems must evolve to meet new challenges – In developed countries, the epidemiological shift in disease burden from acute to chronic diseases over the past 50 years has rendered acute care models of health service delivery inadequate to address the health needs of the population. In developing countries, this shift is occurring at a much faster rate.
Patients need to be supported, not blamed –Despite evidence to the contrary, there continues to be a tendency to focus on patient-related factors as the causes of problems with adherence, to the relative neglect of provider and health system-related determinants. These latter factors, which make up the health care environment in which patients receive care, have a major effect on adherence.
