Interventions to optimize Medication Adherence and Management of Non-Communicable Diseases in LMIC: What is Feasible, Sustainable, and Works?

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Background

Non-communicable diseases (NCDs) is the major cause of death worldwide, with more than 80% of them occurred in low- and middle-income countries (LMIC). This is getting worse since, over the next 10 years, it is estimated that death due to NCDs are likely to increase by 17% globally and 27% in Africa resulting in additional 28 million deaths thereby exceeding deaths caused by communicable, maternal, perinatal and nutritional diseases collectively. Furthermore, in Africa, it is predicated that NCDs will soon be the leading cause of illness and premature mortality resulting in substantial negative impact on the region’s socioeconomic development.

In addition to life-style changes, pharmacotherapy is the key for the management of NCDs; however, this requires patients to be adherent to their medications which is, unfortunately, the major barrier for effective NCD management. Medications’ non-adherence affects up to 30-50% of patients resulting not only in increased mortality and morbidity but also increased healthcare costs with subsequent burden on country’s economy. The WHO, therefore, considers the burden of medication non-adherence as an important public health concern, necessitating urgent action. Non-adherence to medications is multi-factorial but it gets further complicated in LMIC by issues of access and affordability of medicines with high co-payments.

Optimizing medication adherence and management of NCD, especially for highly prevalent conditions such CVD and diabetes, is crucial to reduce the burden of these NCD. Many interventions, including the use of digital or mobile technologies, have been developed to optimize medication adherence but the majority of these have been developed and implemented in non-LMIC settings; hence their effectiveness, feasibility, and substantiality in LMIC settings are unclear. There is need for interventions tailored to LMIC settings that are feasible and sustainable given the limited resources available in these settings. The aim and scope of this research topic is to promote research around developing interventions to optimize medication adherence and management of NCD, particularly CVD and diabetes, that are sustainable in LMIC outside the research context. Furthermore, exploring the most effective, reliable and validated adherence measurement tools in LMIC given the very limited or lack of patients’ electronic records. This needs multidisciplinary collaborations between clinicians, computer and digital science, health economists, health system and policy makers and patient groups. Original Research addressing the stated aim/scope will be considered; Systematic Reviews and meta-analysis with strong rationale relevant to the topic would be also considered.

Topic Editor Maribel Salas is employed by Daiichi Sankyo, USA. All other Topic Editors declare no other competing interest with regards to the Research Topic subject.

Keywords: Adherence, LMIC, NCD, Interventions, Health policy

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