Role of Ageing Patients – A Call For Empowerment

Brussels, 15 May 2012 Alexander Roediger

Three Issues Dominating The Debate
1. Demographic change – decreasing workforce 2. Increase of chronic diseases, also amongst

working age population
3. Europe’s economic crisis putting pressure on

health systems



Ageing Population Due To Decreasing Fertility and Longer Life Expectancy Between 2015 and 2035, the population aged 60 and above will be increasing by 2 million people every year … ... while fertility decreases
Sources: Council of Europe (7/6/2010), Council Concusions on Active Ageing
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... Shrinking Workforce

European working age population is expected to be shrinking between 2020 and 2060 by 13.6%, i.e. 33 million people
Sources: European Commission (DG ECFIN) and the Economic Policy Committee (AWG) (2009), The 2009 Ageing Report: economic and budgetary projections for the EU-27 Member States (2008-2060), p. 54; World Economic Forum (WEF) (2012), The Workplace Wellness Alliance. Investing in a sustainable workforce; in collaboration with the Boston Consulting Group, p. 5
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Multiple Chronic Conditions Already In Working Age Chronic diseases are responsible for 63% of annual deaths, including nearly 50% of premature deaths affecting people under the age of 70 in their productive years

Sources: International Social Security Association (issa) (2011), (accessed: 26/02/2012); Bloom, D.E., Cafiero, E.T., Jané-Llopis, E., Abrahams-Gessel, S., Bloom, L.R., Fathima, S., Feigl, A.B., Gaziano, T., Mowafi, M., Pandya, A., Prettner, K., Rosenberg, L., Seligman, B., Stein, A.Z., & Weinstein, C. (2011), The Global Economic Burden of Noncommunicable Diseases. Geneva: World Economic Forum, p. 5

Meeting the Maastricht Criteria Will Be Difficult

Sources: Bernstein Research (08/03/2012)
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Health Literacy – The Link Between Better Outcomes And Sustainable Healthcare?
Life course Societal and environmental determinants Situational Determinants

Health service use Understand Access Knowledge Motivation Health information Competences Appraise Health care Disease prevention Health promotion Health behavio r

Health costs

Health outcome s

Particip a-tion

Empow er-ment

Personal Determinants

Apply Equity


Individual level

Population level

Source: Pelikan J et al. (2011), The European Health Literacy Project; findings presented at the European Health Literacy Conference in Brussels on 22/23 November 2011
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Lower Health Literacy Levels At Higher Age

Source: Pelikan J et al. (2011), The European Health Literacy Projcet; findings presented at the European Health Literacy Conference in Brussels on 22/23 November 2011
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More Healthcare Use At Lower Health Literacy Levels

Health Literacy level

Doctor‘s visits
Source: Pelikan J et al. (2011), The European Health Literacy Projcet; findings presented at the European Health Literacy Conference in Brussels on 22/23 November 2011
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Adherence Is A Complex Problem – Improving Adherence Is An Opportunity
► Average adherence in chronic

diseases is only 50% according to WHO ► According to a survey of Boston Consulting Group amongst 13,533 patients over 18 years in the US – almost every third patient did not take the medication accordingly – every fourth delayed filling a prescription – every fifth stopped taking a prescription medication sooner than prescribed
Sources: WHO (2003), Adherence to Long-term Therapies. Evidence for Action (Geneva); Boston Consulting Group (BCG, 2003), The Hidden Epidemic. Finding a Cure for Unfilled Prescriptions and Missed Doses; in:; USA Today (29/3/2007), Doctors baffled by patients not taking prescriptions (29.03.2007); see:
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Empowered Citizens Can Be A Bridge Towards Better Health And Sustainable Healthcare
“Health literacy is the capacity to make sound health decisions in the context of every day life.”
Better health outcomes

Health Literacy

Multi-stakeholder programs beyond products to the benefit of patients‘ health

Better use of resources

Sources: Kickbusch I and Maag D Health Literacy. In: Kris Heggenhougen and Stella Quah, editors International Encyclopedia of Public Health, Vol 3. San Diego: Academic Press; 2008. pp. 204-211
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Cornerstones To Support Citizens And Patients In Times Of Demographic Change
► Citizen/ patient involvement (health literacy) and

better coordination of healthcare providers support better health outcomes and contribute to sustainability

► Joint effort, i.e. integrated healthcare approach,

of all stakeholders needed to meet citizens‘ and patients‘ needs and to improve the „readability“ of the health system

► Policies that set the framework and trigger actions
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