, Volume 26, Issue 12, pp 1391-1393
Date: 31 Aug 2011

The Importance of Social Ties in Sustaining Medication Adherence in Resource-Limited Settings

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Ten years ago the late John Eisenberg, along with Elaine Powers, elaborated a conceptual framework to explain unachieved potential for high-quality care delivery in the US, analogous to the voltage drops that occur as an electrical current flows through a series of resistors.1 Using an adapted version of their framework, one can appreciate that a mix of public health and health care strategies will be needed to address the growing burden of cardiovascular disease in resource-limited settings. Many countries' efforts to reduce cardiovascular risk at the population level are hampered by unaffordable (or unavailable) health insurance schemes; fragmented, acute care-oriented health care systems; and weak primary care infrastructures.2,3 Even if these sizable voltage drops are addressed, potential quality will be further dissipated through another series of resistors: patients must seek evaluation for treatment4; health care workers must be consistently available5 to provide patients with a