Adherence to antimalarial treatments in the real world - does it really matter?

摘要

Adherence, compliance, concordance - whichever term you prefer, all refer to the extent to which patients take their medication as prescribed. The three key elements involve taking a medicine at the right dose, the correct dosing frequency and for the recommended treatment duration. Failure to take medicines as recommended has negative consequences; for some therapeutic areas, such as the treatment of musculo-skeletal disorders with non-steroidal anti-inflammatory drugs, poor adherence may 'only' result in inadequate symptom control. For diseases such as uncomplicated malaria, the consequences can be far more serious; sub-optimal adherence has been associated with treatment failure, severe malaria and death. For example, Siddiqui et al. reported patients returning to a Medecins Sans Frontieres clinic in the Democratic Republic of the Congo with severe malaria despite having been prescribed artemisinin-based combination therapy (ACT) treatment.