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Two out of three patients with major depression do not correctly follow the treatment prescribed by their doctor

This year, World Health Day, which is to be celebrated on Friday, has been dedicated to depression
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07.04.2017

Madrid, April 5, 2017. – About 2.4 million people in Spain are diagnosed with major depression, a disease that this year is the focus of World Health Day. On this occasion, the World Health Organization (WHO) recalls that depression is a frequent disease, which is the world’s leading cause of disability and can become a serious health problem up to the point that, and in the most serious cases, can lead to suicide.

Although, according to the international organization itself, there are effective treatments against depression, more than half of those affected worldwide (and more than 90% in many countries) do not receive such treatments due to, among other causes, resources and trained health personnel, in addition to the stigmatization of mental disorders and inaccuracies in diagnosis.

Alongside this, in countries with a strong health care system there is a problem that makes it difficult to approach this pathology: lack of adherence to the prescribed pharmacological treatments. In Spain’s case, 72% of patients diagnosed and treated, do not adequately follow the prescription given by their doctor. This results in a higher rate of relapse, with obvious consequences on the quality of life for the patient (health care demands, urgent care and hospital admissions), their family and other social circles. This situation results in significant direct health expenditure, avoidable if the adherence of these patients to the treatments prescribed by their doctor is improved, according to data from the Plan of Adherence to the Treatment (Responsible use of the medicine), document created by different medical scientific societies, pharmacies and nursing and patient organizations and driven by FARMAINDUSTRIA.

Specifically, major depression is the one with the lowest adherence rate, with 28%, followed by chronic obstructive pulmonary disease (41%), hypertension (52%) and diabetes (56%). Pathologies such as cancer and HIV infection have higher rates of therapeutic compliance, with 70% and 80% respectively.

Less relapse and reduction of health expenditure

The Treatment Adherence Plan also includes an economic study, carried out with the collaboration of the CRES (Pompeu Fabra University), which allows for the estimation of the benefits of improved adherence rates for the patient, avoiding relapses, and for the system, by reducing health spending. Thus, raising a percentage point the rate of adherence to treatments would translate immediately into 2,572 fewer relapses. Therefore, increasing this rate by ten percentage points, from 28% to 38%, would prevent 25,700 relapses. If all patients followed the treatment, direct avoidable health expenditure would amount to close to €100 million.

According to the authors of the Plan, it is evident that “the development of interventions aimed at favouring the compliance of patients with major depression would result in a significant improvement, both in terms of disease management and avoided expenses, thus, on the sustainability of the National Health System.” As stated in the Plan, in order to improve adherence rates, it is essential to involve all health professionals (doctors, nurses, pharmacists and clinical psychologists, amongst others) in a comprehensive and coordinated manner, and call upon patient and family associations to play their key role.

In the same vein, it should also be taken into account that, as indicated in a study conducted by the WHO and published in April 2016 by The Lancet Psychiatry, for every one dollar invested worldwide in the expansion of depression and anxiety treatment, four dollars will be generated in improving the health and work capacity of patients, which means that the investment to improve the treatment of this disease has a yield of 400%.

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