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.
| Original language | English |
|---|---|
| Article number | 944829 |
| Journal | Frontiers in Pharmacology |
| Volume | 13 |
| DOIs | |
| Publication status | Published - 11 Aug 2022 |
Bibliographical note
Publisher Copyright:Copyright © 2022 Kardas, Bago, Barnestein-Fonseca, Garuolienė, Granas, Gregório, Hadžiabdić, Kostalova, Leiva-Fernández, Lewek, Mala-Ladova, Schneider, van Boven, Volmer, Ziampara and Ágh.
Funding
Therefore, it is of particular interest to study the enabling mechanisms for the wide-scale implementation of effective MAEIs. One of the major ones is their reimbursement. However, current literature lacks information on this issue, which precludes cross-border benchmarking of effectiveness of various reimbursement models and taking lessons from good practices that have already been identified. This was one of the major stimuli to create a novel network of European researchers, launched in 2020 under the name of “European Network to Advance Best practices & technoLogy on medication adherencE” (ENABLE). The ENABLE is a COST Action, funded by the European Commission, which brings together researchers from 39 European countries and Israel. ENABLE aims to raise awareness of adherence enhancing solutions, foster and extend multidisciplinary knowledge on medication adherence at patient, treatment, and system levels; accelerate translation of this knowledge from producers to useful clinical application; and work collaboratively towards economically viable policy and implementation of adherence enhancing technology across different European healthcare systems (). ENABLE is composed of four cohesive Working Groups (WGs) among which WG3 aims to facilitate the implementation of MAEIs in European healthcare settings. To obtain this goal, ENABLE WG3 is going to review national healthcare systems as well as the reimbursement pathways for adherence-enhancing technologies across different European countries. This will further allow comparative analysis, and benchmarking of various reimbursement models. This is very important since currently only a few countries systematically monitor adherence, and international benchmarking is still not in place (). This research is based upon work from COST Action CA19132 “ENABLE,” funded by COST (European Cooperation in Science and Technology). The funder had no role in the study design, data collection, analysis and interpretation, or preparation of the manuscript.
| Funders | Funder number |
|---|---|
| European Commission | |
| European Cooperation in Science and Technology | CA19132 |
Keywords
- Europe
- drugs
- healthcare systems
- interventions
- medication adherence
- non-adherence
- persistence
- reimbursement