title: Impact of the financial crisis on adherence to treatment of a rural population in Crete, Greece.
abstract: BACKGROUND
  The global economic crisis has affected Greece. Data on patients' adherence to medications for chronic diseases are missing. The objective of this study was to identify to what extent the financial crisis and the repeated pharmacists strike have influenced patients adherence to therapy.
  
  
  METHODS
  
  
  
  METHODS
  A quantitative and qualitative study in rural Crete was designed and implemented in February 2013 with the use of a pretested questionnaire with opened and closed questions. Setting Rural practices in a well-defined geographical area of Crete.
  
  
  METHODS
  The questionnaire was addressed in all patients that visited the rural practices with chronic or acute diseases for two consecutive weeks. Main Outcome(s) and Measure(s): Age, annual income, adherence to therapy, patient's views and feelings.
  
  
  RESULTS
  288 patients participated. The mean age was 68±6.87. The majority of the patients have lowered the doses of several medications by themselves as they weren't able to afford the cost ie; all patients receiving insulin had lowered the dosages; 46.42% of patients with COPD or asthma had stopped their medications completely, decreased dosages or used similar medications that had in the past; patients with dislipidemia received their medications as suggested only in 51.8%. Patients with cardiovascular diseases received their medications as suggested in 75.6% while the rest have dismissed or skipped dosages. Most common emotions reported were those of sadness, fear, stress, anxiety and isolation.
  
  
  CONCLUSIONS
  The economic crisis has influenced patients' adherence to therapy in rural areas as well as their psychological and emotional status. There is an urgent need for action within the context of primary care.
authors.affiliation: Asites rural practice, Agia Barbara Health Care Centre, Heraklion, Crete, Greece Cretan Practice-based Primary Care Research Network 'G. Lambrakis' & Clinic of Social and Family Medicine, School of Medicine, University of Crete, Heraklion, Crete, Greece;, Email: i.tsiligianni@hotmail.gr.
authors.forename: Ioanna G
authors.initials: IG
authors.lastname: Tsiligianni
authors.affiliation: Cretan Practice-based Primary Care Research Network 'G. Lambrakis' & Clinic of Social and Family Medicine, School of Medicine, University of Crete, Heraklion, Crete, Greece Garipa rural practice, Arkalohori Health Care Centre, Crete, Greece.
authors.forename: Polyvios
authors.initials: P
authors.lastname: Papadokostakis
authors.affiliation: Cretan Practice-based Primary Care Research Network 'G. Lambrakis' & Clinic of Social and Family Medicine, School of Medicine, University of Crete, Heraklion, Crete, Greece Peza rural practice, Arkalohori Health Care Centre, Crete, Greece.
authors.forename: Dimitra
authors.initials: D
authors.lastname: Prokopiadou
authors.affiliation: Cretan Practice-based Primary Care Research Network 'G. Lambrakis' & Clinic of Social and Family Medicine, School of Medicine, University of Crete, Heraklion, Crete, Greece Embaros rural practice, Viannos Health Care Centre, Crete, Greece.
authors.forename: Ioanna
authors.initials: I
authors.lastname: Stefanaki
authors.affiliation: Cretan Practice-based Primary Care Research Network 'G. Lambrakis' & Clinic of Social and Family Medicine, School of Medicine, University of Crete, Heraklion, Crete, Greece Malia surgery, Kastelli Health Care Centre, Crete, Greece.
authors.forename: Nikolaos
authors.initials: N
authors.lastname: Tsakountakis
authors.affiliation: Cretan Practice-based Primary Care Research Network 'G. Lambrakis' & Clinic of Social and Family Medicine, School of Medicine, University of Crete, Heraklion, Crete, Greece.
authors.forename: Christos
authors.initials: C
authors.lastname: Lionis