Urging Europe to put non-adherence to inhaled respiratory medication higher on the policy agenda: a report from the First European Congress on Adherence to Therapy

"Drugs don't work in patients that don't take them" are the by now almost legendary words of former US Surgeon General C. Everett Koop. Arguably worse than "just not working", for the European Union (EU), it has been estimated that non-adherence to medication is associated with almost 200 000 deaths and an excess cost of EUR80-125 billion [1]. Realising that 1) non-adherence affects about 50% of chronic medication users [2], of which the large majority elderly, and 2) tackling non-adherence requires a joint effort, the Senior International Health Association took the initiative to bring together seniors, clinical and adherence experts, and European Parliament members. On November 18 and 19, 2016, all these key stakeholders met at the First European Congress on Adherence to Therapy in Rimini, Italy, passionately chaired by Giovanni La Via, President of the Environment, Public Health and Food Safety Committee of the European Parliament. Notably, there were representatives from several major European scientific societies, i.e. those of pulmonology (ERS), atherosclerosis (EAS), urology (EAU), heart rhythm (EHRA), psychiatry (EPA), cardiology (ESC) and hypertension (ESH). The overall goal of the congress was to identify unmet needs in adherence research, funding and policy by specifying the roles of patients, healthcare providers, societies, funding bodies and governments. In this report, we present the main conclusions and recommendations following the congress, in particular those of interest for healthcare policy regarding inhaled medication non-adherence in patients with obstructive airway diseases (i.e. asthma and/or chronic obstructive pulmonary disease (COPD)).