Overcoming barriers to patient adherence: the case for developing innovative drug delivery systems.

Poor medication adherence is a pervasive issue with considerable health and socioeconomic consequences. Although the underlying reasons are generally understood, traditional intervention strategies rooted in patient-centric education and empowerment have proved to be prohibitively complex and/or ineffective. Formulating a pharmaceutical in a drug delivery system (DDS) is a promising alternative that can directly mitigate many common impediments to adherence, including frequent dosing, adverse effects and a delayed onset of action. Existing DDSs have already positively influenced patient acceptability and improved rates of adherence across various disease and intervention types. The next generation of systems have the potential to instate an even more radical paradigm shift by, for example, permitting oral delivery of biomacromolecules, allowing for autonomous dose regulation and enabling several doses to be mimicked with a single administration. Their success, however, is contingent on their ability to address the problems that have made DDSs unsuccessful in the past. Improving medication adherence is recognized as one of the most impactful and cost-effective strategies for improving the health of the general population. Here, Baryakova and colleagues assess the potential of next-generation drug delivery systems to mitigate many common impediments to adherence and discuss the impact that drug delivery systems have had across different disease types.

药物依从性差是一个普遍存在的问题，会对健康和社会经济产生重大影响。尽管其根本原因已大致了解，但以患者为中心的教育和赋权为基础的传统干预策略已被证明极其复杂和/或无效。将药物制成药物递送系统（DDS）是一种很有前景的替代方法，它可以直接缓解许多常见的依从性障碍，包括频繁给药、不良反应和起效延迟。现有的药物递送系统已经对患者的接受度产生了积极影响，并提高了各种疾病和干预类型的依从率。下一代系统有可能带来更彻底的范式转变，例如，允许生物大分子口服给药、实现自主剂量调节以及通过单次给药模拟多次剂量。然而，它们的成功取决于能否解决过去导致药物递送系统不成功的问题。 提高药物依从性被认为是改善普通人群健康最具影响力且最具成本效益的策略之一。在此，巴里亚科娃及其同事评估了下一代药物递送系统缓解许多常见依从性障碍的潜力，并讨论了药物递送系统在不同疾病类型中的影响。