Health professionals need to be trained in adherence – Health providers can have a significant impact by assessing risk of non-adherence and delivering interventions to optimise adherence. To make this practice a reality, practitioners must have access to specific training in adherence management, and the systems in which they work must design and support delivery systems that respect this objective. For empowering health professionals an ‘adherence counselling toolkit’ adaptable to different socioeconomic settings is urgently needed. Such training needs to simultaneously address three topics: knowledge (information on adherence), thinking (the clinical decision-making process) and action (behavioural tools for health professionals).
Family, community and patients’ organisations: a key factor for success in improving adherence –For the effective provision of care for chronic conditions, it is necessary that the patient, the family and the community who support him or her all play an active role. Social support, (ie, informal or formal support received by patients from other members of their community), has been consistently reported as an important factor affecting health outcomes and behaviours. There is substantial evidence that peer support among patients can improve adherence to therapy while reducing the amount of time devoted by the health professionals to the care of chronic conditions.
A multidisciplinary approach towards adherence is needed –A stronger commitment to a multidisciplinary approach is needed to make progress in this area. This will require coordinated action from health professionals, researchers, health planners and policy-makers.
