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

P. Kardas, M. Bago, P. Barnestein-Fonseca, K. Garuolienė, AG. Granas, J. Gregório, MO. Hadžiabdić, B. Kostalova, F. Leiva-Fernández, P. Lewek, K. Mala-Ladova, MP. Schneider, JFM. van Boven, D. Volmer, I. Ziampara, T. Ágh

. 2022 ; 13 (-) : 944829. [pub] 20220811

Language English Country Switzerland

Document type Journal Article, Review

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.

CBIOS Universidade Lusófona's Research Center for Biosciences and Health Technologies Lisbon Portugal

Center for Health Technology Assessment and Pharmacoeconomic Research University of Pécs Pécs Hungary

Centre for Applied Pharmacy Faculty of Pharmacy and Biochemistry University of Zagreb Zagreb Croatia

CUDECA Institute for Training and Research in Palliative Care CUDECA Hospice Foundation Málaga Spain

Department of Clinical Pharmacy and Pharmacology Medication Adherence Expertise Center of the Northern Netherlands University Medical Center Groningen University of Groningen Groningen Netherlands

Department of Social and Clinical Pharmacy Faculty of Pharmacy in Hradec Kralove Charles University Hradec Kralove Czech Republic

Faculty of Medicine Institute of Pharmacy University of Tartu Tartu Estonia

Health Insurance Organization National Health Insurance System Nicosia Cyprus

Institute of Pharmaceutical Sciences of Western Switzerland University of Geneva Geneva Switzerland

Instituto de Investigación Biomédica de Málaga IBIMA Group C08 Pharma Economy Clinical and Economic Evaluation of Medication and Palliative Care Málaga Spain

Medication Adherence Research Centre Department of Family Medicine Medical University of Lodz Lodz Poland

Multiprofessional Teaching Unit of Community and Family Care Primary Care District Málaga Guadalhorce Andalusian Health Service Instituto de Investigación Biomédica de Málaga IBIMA Group C08 Málaga Spain

Norwegian Centre for E health Research University Hospital of North Norway Tromsø Norway

Pharmacy Center Institute of Biomedical Science Faculty of Medicine Vilnius University Vilnius Lithuania

Reference Center of Pharmacoepidemiology Research and Teaching Department Andrija Stampar Teaching Institute of Public Health Zagreb Croatia

School of Pharmaceutical Sciences University of Geneva Geneva Switzerland

Section for Pharmaceutics and Social Pharmacy Department of Pharmacy University of Oslo Oslo Norway

Syreon Research Institute Budapest Hungary

References provided by Crossref.org

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$a 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.
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