“Drugs don’t work in people that don’t take them” (C. Everett Koop, former US Surgeon General). Mainly due to an ageing society, there is a steady increase in the number of patients with a chronic disease and multi-morbidity. This requires a multifaceted response, which often involves lifetime medication use.
Most medications have proven their efficacy in large randomised clinical trials. Yet, in real-life practice, the effectiveness of medications is often much lower. A main reason is poor medication adherence. Medication non-adherence affects, depending on disease and definitions applied, up to 50% of patients that use chronic medication. Of note, it has been estimated that medication non-adherence is associated with almost 200,000 deaths and €125 billion of potentially preventable direct costs, such as hospital admissions and drug waste, and indirect ones, such as loss of work productivity, in the European Union alone.
In the last decades, there has been little improvement in adherence across the spectrum of multiple chronic diseases. The fragmentation of adherence research, poor awareness among stakeholders, lack of effective and personalised strategies, and poor implementation and incentives in daily clinical practice are some of the key factors that little progress and change have been realised. To truly advance the adherence field, to make better use of our existing medications, and ultimately improve healthy ageing of societies, the time has come to unite all forces within one adherence expertise center that serves as a knowledge hub as well as implementation platform.