Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2022 Aug 11:13:944829.
doi: 10.3389/fphar.2022.944829. eCollection 2022.

Reimbursed medication adherence enhancing interventions in 12 european countries: Current state of the art and future challenges

Przemysław Kardas  1 , Martina Bago  2 , Pilar Barnestein-Fonseca  3 , Kristina Garuolienė  4 , Anne Gerd Granas  5   6 , João Gregório  7 , Maja Ortner Hadžiabdić  8 , Barbora Kostalova  9 , Francisca Leiva-Fernández  10 , Pawel Lewek  1 , Katerina Mala-Ladova  9 , Marie Paule Schneider  11   12 , Job F M van Boven  13 , Daisy Volmer  14 , Ioli Ziampara  15 , Tamás Ágh  16   17
Affiliations
Review

Reimbursed medication adherence enhancing interventions in 12 european countries: Current state of the art and future challenges

Przemysław Kardas et al. Front Pharmacol. .

Abstract

Background: Medication non-adherence jeopardises the effectiveness of chronic therapies and negatively affects financial sustainability of healthcare systems. Available medication adherence-enhancing interventions (MAEIs) are utilised infrequently, and even more rarely reimbursed. The aim of this paper was to review reimbursed MAEIs across selected European countries. Methods: Data on reimbursed MAEIs were collected from European countries at the ENABLE Cost Action expert meeting in September 2021. The identified MAEIs were analysed and clustered according to their characteristics, direct vs. indirect relation to adherence, and the targeted adherence phase. Results: Out of 12 contributing countries, 10 reported reimbursed MAEIs, 28 in total, of which 20 were identified as MAEIs targeting adherence directly. Reimbursed MAEIs were most often performed by either doctors (n = 6), nurses (n = 6), or pharmacists (n = 3). The most common types of MAEIs were education (n = 6), medication regimen management (n = 5), and adherence monitoring feedback (n = 4). Only seven reimbursed MAEIs were technology-mediated, whereas 11 addressed two interlinked phases of medication adherence, i.e., implementation and persistence. Conclusion: Our review highlights the scarcity of reimbursed MAEIs across the selected European countries, and calls for their more frequent use and reimbursement.

Keywords: Europe; drugs; healthcare systems; interventions; medication adherence; non-adherence; persistence; reimbursement.

PubMed Disclaimer

Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

FIGURE 1
FIGURE 1
Adherence phases addressed by various reimbursed MAEIs directly targeting adherence, identified across analysed countries. * INITIAT, initiation; IMPLEMENT, implementation; PERSIST, persistence; UNDEF, undefined.
FIGURE 2
FIGURE 2
Scheme of iterative medication adherence-bettering process, involving reimbursement of medication adherence enhancing interventions.
See this image and copyright information in PMC

References

    1. Aardoom J. J., Loheide-Niesmann L., Ossebaard H. C., Riper H. (2020). Effectiveness of eHealth interventions in improving treatment adherence for adults with obstructive sleep apnea: Meta-analytic review. J. Med. Internet Res. 22 (2), e16972. 10.2196/16972 - DOI - PMC - PubMed
    1. Ágh T., van Boven J. F., Wettermark B., Menditto E., Pinnock H., Tsiligianni I., et al. (2021). A cross-sectional survey on medication management practices for noncommunicable diseases in Europe during the second wave of the COVID-19 pandemic. Front. Pharmacol. 12, 685696. 10.3389/fphar.2021.685696 - DOI - PMC - PubMed
    1. Clyne W., McLachlan S., Mshelia C., Jones P., De Geest S., Ruppar T., et al. (2016). "My patients are better than yours": Optimistic bias about patients' medication adherence by European health care professionals. Patient prefer. Adherence 10, 1937–1944. 10.2147/PPA.S108827 - DOI - PMC - PubMed
    1. Cross A. J., Elliott R. A., Petrie K., Kuruvilla L., George J. (2020). Interventions for improving medication-taking ability and adherence in older adults prescribed multiple medications. Cochrane Database Syst. Rev. 5, CD012419. 10.1002/14651858.CD012419.pub2 - DOI - PMC - PubMed
    1. Cutler R. L., Fernandez-Llimos F., Frommer M., Benrimoj C., Garcia-Cardenas V. (2018). Economic impact of medication non-adherence by disease groups: A systematic review. BMJ Open 8, e016982. 10.1136/bmjopen-2017-016982 - DOI - PMC - PubMed