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Vast global resources are ploughed into the delivery of treatment interventions ranging from diet and lifestyle advice through to complex surgery. In all cases, whatever the intervention, unless the recipient is engaged with the process and understands why the intervention has been offered and the part they play in its success, compliance will be an issue. Even where the individual does engage and understand, he or she may choose, in the light of that knowledge, not to comply. This book aims to explore the key factors which drive compliance and the part that healthcare professionals can play in improving this, with the key underlying goal of improving public health in its broadest sense. During clinical trials, non-compliance undermines the accuracy of the data generated from the whole trial as well as particular aspects such as the efficacy of different dosages. In more general treatment of patients, improving compliance improves the real world effectiveness of treatments, which benefits healthcare providers and the pharmaceutical industry alike. Western medicine faces a number of key challenges, not least: an aging population requiring increasing levels of treatment and prescription, spiralling costs of technology and treatment, and growing levels of viral resistance to drugs. Non-compliance is estimated to cost the pharma industry US$70 billion per year. No figures exist for the cost to healthcare insurers and public health but non-compliance is undoubtedly one of the top five issues facing both drug developers and healthcare providers.
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Patient Compliance: Sweetening the Pill This page intentionally left blank Patient Compliance: Sweetening the Pill Edited by Dr Madhu Davies and Dr Faiz Kermani ‘Patient compliance is a multidimensional, multinational, and multidisease state problem.’ Dr Jane Chin © Madhu Davies and Faiz Kermani 2006 All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted in any form or by any means electronic, mechanical, photocopying, recording or otherwise without the prior permission of the publisher. Published by Gower Publishing Limited Gower House Croft Road Aldershot Hampshire GU12 3HR England Gower Publishing Company Suite 420 101 Cherry Street Burlington, VT 05401-4405 USA Madhu Davies and Faiz Kermani have asserted their right under the Copyright, Designs and Patents Act 1988 to be identified as the authors of this work. British Library Cataloguing in Publication Data Patient compliance : sweetening the pill 1. Patient compliance I. Davies, Madhu II. Kermani, Faiz 615.5 ISBN-10: 0 566 08658 1 ISBN-13: 978-0-566-08658-8 Library of Congress Control Number: 2006935176 Typeset in Bembo by IML Typographers, Birkenhead, Merseyside Printed in Great Britain by MPG Books Ltd., Bodmin, Cornwall Contents List of Figures and Tables List of Abbreviations List of Contributors Preface Part 1 What is Compliance? vii ix xi xvii 1 1 Patient Compliance: Setting the Scene Dr Faiz Kermani and Dr Madhu Davies 3 2 View from the Real World Dr John Parkinson, Dr Li Wei and Professor T.M. MacDonald 7 3 Health Economic Aspects of Patient Non-compliance Dr Dyffrig Hughes Part 2 The Challenge of Compliance 23 41 4 Patient Compliance in the Prevention and Treatment of Cardiovascular Disease Professor Gregory M. Peterson and Dr Shane L. Jackson 43 5 Patient Compliance:A French Perspective Catherine Narayan-Dubois 57 Part 3 Building For Success 69 6 Building in Compliance from the Start Janice MacLennan 71 7 Formulating for Compliance Success Dr Akira Kusai, PhD 83 v CONTENTS PATIENT COMPLIANCE: SWEETENING