DEVELOPING STEPS TO IMPROVE ADHERENCE IN HEALTHCARE PROFESSIONALS DAILY PRACTICE
Authors: Lekić Lana , Alibegović Ervin , Rahimić Jasna , Pavlović Bojan , Hamzić-Mehmedbašić Aida 
Published: December 2023

Adherence is a a term that has been prominently used and emphasized recently, representing the connection between a patient and their treatment. Medical adherence has its hierarchical structure, with roots primarily stemming from legislative bodies to the healthcare system, institutions and ultimately healthcare professionals (doctors, nurses, technicians). However, medical adherence faces a significant obstacle in achieving therapy goals and improving treatment outcomes among many patients, especially those with chronic conditions. Social and sociental conditions, as well as the state organization in Bosnia and Herzegovina (BiH), greatly influence the healthcare system and the purchasing power of healthcare service users. Due to significant barriers and challenges regarding adherence, efforts are being made to maintain a system that supports increasing patient adherence levels. Within this research paper, three questionable theses are presented: internal and external education, improvement of the healthcare system and the implementation of systematic data collection on patient adherence. All three questionable thesis recived positive feedback from respondents (200 participants). From the first thesis, 154 respondents voted in favor, for the second thesis, 142 respondents and for the third thesis, 134 respondents agreed with the proposed suggestions. Unfortunately, in BiH insufficinet attention is given to patient adherence and there is no unified strategy to increase adherence levels. Internal and external education would be essential as healthcare workers are not adequately trained, nor are conditions created for its implementation. Increasing the level of adherence can greatly benefit healthcare workers in their daily practice if they have adequate conditions in place. Unfortunately, a significant number of healthcare employees lack the knowledge, experience and a clearly defined strategy on how to increase patient adherence. The complexity of measuring adherence only adds to the intricacy of an already complex problem and the inefficiency and sluggishness of the healthcare system hinder the creation of appropriate activities that should result in increased patient adherence. The patient’s adhrence is influenced by numerous factors for which there is no unique solution or overcoming suggestions. Also, problems in the process of identifying and measuring adherence further complicate the already complex matter and the process of increasing user adherence. Creating a strategy to improve adhrence at the state level in Bosnia and Herzegovina is almost impossible; therefore, the increase in adhrence can only be achived at the level of the patient, healthcare personnel and ideally, at the level of healthcare institutions. Unfortunately, in most cases, conditions and workload do not allow healthcare workers to spend enough time with patients, establish adequate communication and demonstrate that the patient is genuinely important to them. Providing not only the necessary care but also essential information about the illness and treatment can directly impact the level of patient adhrence. The healthcare system in developed countries, although technologically possible, lacks and adequate mechanism for collecting, processing and analyzing data related to the adherence level of patients with a specific condition or in a particular geographic region. Data is often collected based on indirect methods that do not provide accurate and precise information, posing a significant challenge in proving the role and importance of medical adhrence in the healthcare system and treatment outcomes. Considering that the adhrence level ranges from 43% to 78%, which is too high for certain treatment regimens, legislative reforms are needed. In addition to the law and its govering body, it is necssary to ensure all essential materials, from medications to specific medical supplies are provided to all healthcare institutions, hospitals and healthcare centres. Both internal and external education are crucial for patient treatment and therefore it sholud be implemented and carried out on a monthly basis. In addition to healthcare professionals, the education of patients with medical conditions is essential, considering they can be divided into those who are not familiar with using modern technologies to educate themselves and understand the role and significance of medical adherence. Moreover, there are patients who are adept at using modern tchnology to research their condition and treatment options, but they lack sufficinet knowledge and information to assess the accuracy of the available data.