Adherence to treatment as a measure of success in implementing patient support programs

In its latest online edition (2018; DOI: 10.1080/03007995.2018.1536651), Current Medical Research and Opinion publishes the article by Mallik Greene and associates regarding patients’ adherence to the prescribed therapy for schizophrenia treatment and the success of patient support programs.

Many physicians are not entirely aware of their patients’ non-adherence to the prescribed medication. The results of one study show that while the doctors estimated the rate of non‑adherence to the prescribed therapy at 7%, their patients estimated it at 39%.

Chronic conditions require long-term pharmacotherapy, adherence and compliance with treatment. It is estimated that non-adherence to oral drug therapy in patients with schizophrenia reaches 50-70%. A significant issue may be related to side effects, but in some countries it is also associated with the difficulties related to the availability/payment/reimbursement of the therapy.

A study was conducted to assess the adherence to long-acting injectable aripiprazole among patients utilizing the local care centers program. Adherence was measured as proportion of the days covered during follow-up, and it was estimated in patients using the centers for 6 months and 9 months. Patients with the proportion ≥80% were considered adherent to their therapy. Data refer to the period between October 2014 and February 2018. In total, 234 patients were included, i.e. enrolled in the support program; mean age was 37.3 years, 60.7% of males. Medicare insurance in 32.5% of cases covered the cost of medicines – this, of course, is different from the national, Croatian drug payment and reimbursement policy.

There were 157 patients using the centers for at least 6 months, and 87 for 9 months. The proportion of the days covered by treatment was 97% in patients with 6 months of follow-up, while 98% was observed for 9 months of follow-up.

In conclusion, the patients using center services have shown high adherence to drug therapy, suggesting that the injection service (parenteral drug administration) provided by the centers can reduce barriers to treatment and help the patients with schizophrenia adhere to the prescribed therapy.

Although comparable local care centers are not known in the Republic of Croatia, the experience gained from running patient support programs in other therapeutic areas is consistent with the conclusion of the study described. Patient support programs provide clear benefit for the patient and those close to them, health care workers and the health care system, and more.

Patient support programs for Rx pharmaceuticals are financed by the pharmaceutical industry, which, in accordance with the regulations, has no contact with patients and prescribers. Therefore, such programs are executed by independent qualified third party with no interest in turnover and profits from the medication sales. In the context of negotiations between the pharmaceutical industry and the National Health Insurance Fund about medication pricing and reimbursement, patient support programs are not being valued as an investment, positioning them as an undoubtful act of high awareness of patient care, safety and proper therapy, with positive impact on even wider platforms.


Maša Bulajić; MD, MSc Econ, PhD /  Medical Affairs Manager

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