Table 1 Barriers and facilitators to lifestyle and medication adherence for secondary prevention
| Â | Barriers | Facilitators |
|---|---|---|
Healthcare system | – Low funding for non-communicable diseases – Poor access and availability of healthcare – Uninsured out-patient management – Low quality medical education | – Improvement in healthcare systems related to access, affordability, convenience – Better medical education – Involvement of non-medical professionals in healthcare – Multisectoral interventions |
Healthcare providers | – Lack of understanding of patient needs – Neglect to involve patients – Poor focus on lifestyle changes – Prescribing complex regimens – Failure to explain benefits and side effects – Lack of continuity of care – Inappropriate treatment or over-treatment | – Simplifying the medication regimen, combinations, fixed dose combinations, and polypills – Improving patient education, motivation, cost awareness – Elimination of treatment inertia – Training existing community health workers, nurses, and pharmacists – Continual monitoring of patient compliance by physician or other healthcare workers – Assurance of continuity of care |
Patient related | – Social isolation, especially in the elderly – Lack of motivation and commitment – Failure to realize seriousness of problem – Failure to sustain lifestyle changes – Multiple stakeholders and messages – Lack of quality information – Ancillary and drug costs – Universal healthcare and insurance cover | – Patient education and counseling – Self-monitoring of adherence to lifestyles and pharmacotherapy using technology – Behavioral strategies, e.g., self-monitoring of blood pressure and glucose, diaries, memory cues, rewards – Social support by family, health workers, physicians |