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Review
. 2021 Sep 7:14:2453-2465.
doi: 10.2147/JMDH.S313626. eCollection 2021.

New Strategies to Improve Patient Adherence to Medications for Noncommunicable Diseases During and After the COVID-19 Era Identified via a Literature Review

Tarek A Hassan  1 , Jorge Enrique Sáenz  2 , Danute Ducinskiene  3 , Joseph P Cook  1 , Joseph S Imperato  1 , Kelly H Zou  1
Affiliations
Review

New Strategies to Improve Patient Adherence to Medications for Noncommunicable Diseases During and After the COVID-19 Era Identified via a Literature Review

Tarek A Hassan et al. J Multidiscip Healthc. .

Abstract

Noncommunicable diseases (NCDs) place a huge burden on healthcare systems and society as a whole. Relatively early in the coronavirus disease 2019 (COVID-19) pandemic, clinicians became aware that in individuals infected with COVID-19, those with preexisting NCDs such as diabetes mellitus and cardiovascular disease (CVD) were at a greater risk of poor outcomes and mortality than those without. The importance of adherence to medications and lifestyle changes to control and prevent NCDs has been a major focus for many years, but with limited success - the proportion of patients adherent and persistent to their medications remains very low. There are many facets to adherence and persistence. Recent evidence suggests that a patient-centric approach is important, and ensuring that a patient is both motivated and empowered is critical to improving adherence/persistence. The COVID-19 pandemic has brought many changes to the way in which patients with NCDs are managed, with telemedicine and ehealth becoming more common. Changes have also occurred in the way in which patients can gain access to medications during the pandemic. The potential for these changes forms the basis of improving the management of patients with NCDs both during and after the pandemic. Over the coming months, a huge amount of work will be put into initiatives to promote adherence to COVID-19 vaccination programs. Those at highest risk of severe COVID-19, such as people aged 80 years and older, are likely to receive the vaccine first in some parts of world. Finally, social determinants of health are critical elements that can impact not just the likelihood of having an NCD or becoming infected with COVID-19, but also access to healthcare, and a patient's adherence and persistence with their treatments.

Keywords: COVID-19; adherence; ehealth; noncommunicable diseases; patients; persistence; telemedicine.

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Conflict of interest statement

All authors were full-time employees of Viatris (TAH, JES, DD, JPC, JSI and KHZ) when this paper was developed. TAH, JES, DD, JPC, JSI, and KHZ report receiving salaries from the Upjohn a Division of Pfizer, now merged with Mylan to be Viatris and are also stockholders of both Pfizer and Viatris. JSI is now a former employee of Viatris. The authors report no other conflicts of interest in this work.

Figures

Figure 1
Figure 1
Mortality by disease groups in the USA during 2016. Data from World Health Organization.
Figure 2
Figure 2
World Health Organization’s nine voluntary global targets for NCDs to be achieved by 2025, with baseline values from 2010. Data from World Health Organization.
Figure 3
Figure 3
Comorbid NCDs increase the risk of death in patients with COVID-19. Multivariate analysis of patient characteristics associated with mortality in hospital. Based on 20,133 UK patients with COVID-19. #Patient age was compared against <50 years. *P<0.05, **P<0.01. Data from Docherty et al.
Figure 4
Figure 4
The five dimensions of adherence. Data from World Health Organization.
Figure 5
Figure 5
The use of RWD to monitor adherence and persistence over time – an example adherence dashboard.
Figure 6
Figure 6
Adherence in Spain, a case study.
See this image and copyright information in PMC

References

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