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There are people, especially among the elderly, who have to take up to 10 or 12 therapies every day. Maybe you need to keep your heart under control, you suffer from diabetes, the bronchi and lungs are not working at their best, the kidneys are in trouble. Following these treatments is essential, but unfortunately often we take some “vacation” from the therapies or we decide to leave some tablets or we fear the side effects. And adherence to treatments, essential for obtaining the best results in terms of treatment, becomes a dream.
To give an answer to these problems, helping people not to “forget” tablets and the like, Italia Longeva, the National Association for Aging and Active Longevity of the Ministry of Health proposes a “synthetic indicator of adherence” able to become a scale of measurement to better face the situation.
The numbers are impressive
Let’s start with the statistics. With over 8 million over-65s suffering from at least one chronic disease, 5 and a half million having at least three and about 2 million elderly people forced to take at least 10 drugs a day, adherence to care is a key factor in ensuring an active old age and as healthy as possible (chronic diseases are responsible for 80% of the years with disabilities and over 70% of deaths worldwide) and, at the same time, the stability of the National Health System. SN.
Let’s just think of the risk factors for the heart and arteries: adherence levels of at least 80% would make it possible to obtain a total annual saving of 522 million euros for dyslipidemias and 898 million euros for hypertension. “Adherence Pharmacological treatment must be considered an essential parameter to guarantee the health of the population, especially the elderly, and to make our health system more efficient – observes Roberto Bernabei, President of Italia Longeva. It is a topic that has been talked about for years but, to date, there is no valid evaluation tool for all pathologies and easily implemented from Valle d’Aosta to Sicily. The real step forward is the proposal of a synthetic indicator as a standardized strategy for measuring adherence across the country, able to give us a snapshot of the quality of health care and to correct the shot where necessary “.
The document developed by Italia Longeva starts from a systematic review of the literature of the last ten years, aimed at identifying and evaluating the indicators of adherence to therapies for chronic diseases in the Italian population. The analysis, in addition to demonstrating the need to follow the treatments, also reflects on the costs of health care.
“A sub-optimal use of therapies represents one of the major parameters of inefficiency of the NHS – explains Federico Spandonaro, President of CREA Sanità, University of Rome“ Tor Vergata ”. An increase in adherence, although it leads to an increase in pharmaceutical costs, determines a more than proportional reduction in total direct health costs, mainly due to the reduction in medical visits and hospital admissions. The study shows that if levels of adherence to therapies greater than 80% were reached, it would occur a savings annual median per capita of 462 euros for hypertension, 659 euros for dyslipidemias and 572 euros for heart failure “.
How to improve the situation
The analysis document also proposes some possible solutions to make regular treatment easier and more effective. The situation can improve thanks to educational interventions aimed at patients and healthcare personnel, the use of drugs in fixed combination or poly-pills that allow to simplify the therapy, the involvement of pharmacies and health personnel, the monitoring of adherence through ad hoc interventions.
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