title: Adherence: a review of education, research, practice and policy in Switzerland.
abstract: Nonadherence to medication treatment regimens is a major preventable risk behavior in both acute and chronic diseases. Community pharmacists are facilitators in community care for promoting medication adherence and they should implement interdisciplinary medication adherence programs. To do so, pharmacists should be educated in medication adherence, and new pharmaceutical care policies should be implemented. The healthcare system should evolve to better meet the specific needs of patients.
  
  
  OBJECTIVE
  this article describes what has been undertaken in the last decade in medication adherence in terms of education, research, practice and policy in Switzerland.
  
  
  METHODS
  Medline was searched, with the search limited to Switzerland. The three Swiss pharmacy schools were also contacted to collect information about the medication adherence content of both their courses and research programs. National policies related to medication adherence were also reviewed for relevant content.
  
  
  RESULTS
  
  two pharmacy schools offer courses devoted specifically to medication adherence. The number of hours dedicated to the topic varies between 4 to13.
  
  
  METHODS
  a total of 16 studies met the inclusion criteria. Chronic patients were the focus of 9 studies. Medication adherence was the primary outcome of all studies; 10 studies also measured clinical outcomes. Nine studies evaluated the prevalence of medication nonadherence; three studies evaluated the feasibility of new technologies for monitoring adherence; three studies evaluated medication adherence enhancing programs. Policies: three cognitive pharmaceutical services are reimbursed by healthcare insurers, which are directly related to medication adherence.
  
  
  CONCLUSIONS
  Pharmacists in Switzerland have been actively involved in medication adherence research since the mid '90s. Specific medication adherence courses have entered the curriculum of pharmacy schools, and policies in Switzerland are slowly beginning to meet needs of chronic patients by the introduction of pharmaceutical cognitive services and reimbursement fees.
authors.affiliation: Researcher and lecturer in Pharmacy Practice. Community Pharmacy, Dpt of ambulatory care and community medicine, University Hospital , Lausanne ( Switzerland ).
authors.forename: Marie P
authors.initials: MP
authors.lastname: Schneider
authors.affiliation: Pharmacy Practice Unit. Pharmacy School, Universities of Geneva and Lausanne ( Switzerland ).
authors.forename: Isabelle
authors.initials: I
authors.lastname: Krummenacher
authors.affiliation: Pharmacy Practice Unit. Pharmacy School, Universities of Geneva and Lausanne ( Switzerland ).
authors.forename: Hugo
authors.initials: H
authors.lastname: Figueiredo
authors.affiliation: Pharmacy Practice Unit. Pharmacy School, Universities of Geneva and Lausanne ( Switzerland ).
authors.forename: Julien
authors.initials: J
authors.lastname: Marquis
authors.affiliation: Head of Pharmacy Practice Unit. Pharmacy School, Universities of Geneva and Lausanne ( Switzerland ).
authors.forename: Oliver
authors.initials: O
authors.lastname: Bugnon
keywords: Medication Adherence; Pharmacists; Switzerland