Patient Adherence To Medical Treatment Regimens

The single most important public health problem facing physicians today may be the failure of patients to follow their prescribed treatment regimens, a phenomenon that results in treatment failures, increased morbidity and mortality, and enormous burdens to society and the economy. This book focuses on the many factors that influence adherence behavior and discusses how this behavior can be improved. Drawing on data from social, personality, clinical, and health psychology, a leading authority on the subject examines the psychosocial, demographic, contextual, and provider determinants of patient compliance with physician recommendations and stresses their multiplicative influence. Alan J. Christensen presents several theories to account for this behavior and then offers his own new interactional framework, one that applies broader fundamental theorizing about psychological and behavior change to the problem and thereby sheds new light on efforts to promote adherence.

Despite its direct effect on a patient’s health, the literature on treatment adherence does not yet include a summary of proven methods for identifying and addressing patient non-adherence. Improving Patient Treatment Adherence Across Multiple Behaviors: A Clinician's Guide differs significantly from many treatment adherence books on the market by focusing on clinicians and the practical tactics they need to improve patient adherence. The book is orgnaized by behavior and special issues as opposed to other texts, which look at treatment adherence as a theoretical concept. Each chapter provides a summary of existing literature regarding the impact of patient non-adherence, including costs, clinical outcomes and health-related quality of life, as well as a review of patient factors related to treatment adherence across behaviors, diseases, and special populations. A discussion of methods for improving treatment adherence takes a look at both proven methods and new technological advances in the field. Each chapter includes a table listing 3-5 key bullets that a clinician could use to address treatment adherence. Actual questions and scoring algorithms for widely used measures of treatment adherence make this book a useful guide for practicing clinicans.

This report is based on an exhaustive review of the published literature on the definitions, measurements, epidemiology, economics and interventions applied to nine chronic conditions and risk factors.

This title synthesizes the results from more than 50 years of empirical research, resulting in simple, powerful, and practical guidance for health professionals who want to know the most effective strategies for helping their clients to put long-term health-relevant behaviour changes into practice.

1. It is incumbent on medical providers that they are asking patients to - here to regimens with demonstrated eficacy, Providers need to remind themselves of the Hippocratic oath: "I will follow that system of regimen which, according to my ability and judgment, I consider for the benefit ofmy patients, and abstain from whatever is deleterious and mischievous" (as cited in Cassell, 199 1, p. 145). 2. Providers need to abandon the "blame and shame" approach to dealing with medical adherence problems. It is tempting to blame patients for adherence failures and shame them into changing their behavior. Providers need to share the blame (or better yet omit blame) and look at their own attitudes and behaviors that impact adherence. For example, failing to simplify regimens or minimize negative side effects can adversely impact patient adherence. 3. Patients and their families are no longer (or maybe were never) satisfied with apassive role in their health care. In fact, the tern compliance lost favor in the literature because it implied for some an authoritarian approach to health care that required unquestioned obedience by patients to provider recommendations (DiMatteo & DiNicola, 1982). Comprehensive and effective health care requires a cooperative relationship between providers and patients and their families. It also acknowledges the following realities, particularly for treating persons with chronic illness: "Doctors do not treat chronic illnesses. The chronically ill treat themselves with the help of their physicians; the physician is part of the treatment.

This new book summarizes the adherence literature for a number of specific health behaviors and populations. It provides a comprehensive source on the conceptualization, interventions, and measurement of treatment adherence and a synthesis of the research across demographic and chronic diseases. The text presents problems associated with treatment adherence; theoretical models that have commonly been used to understand, predict, and/or improve adherence; adherence with specific behaviors including exercise, diet, rehabilitation, medication, and psychological therapies; and strategies in enhancing adherence. Because chronic diseases involve similar behaviors, the handbook is organized by specific behaviors and special populations, and not by disease. Every chapter is sub-organized by specific diseases to ensure easy access for the readers and features a discussion of adherence across demographic and chronic conditions, a review of previous interventions directed at the particular behavior or population, questions and scoring algorithms for widely used measures of treatment adherence, a discussion of the clinical research, and where appropriate, policy implications. Patient Treatment Adherence addresses: practical recommendations to improve adherence; the impact of non-adherence including costs and health-related quality of life; methodological issues such as assessing cost-effectiveness; and the use of technological advances to improve adherence. Intended for health service professionals, health, clinical, social, and cognitive psychologists, primary care physicians, pharmacists, and policy-makers, this text is also an excellent resource for graduate courses on health psychology and public health.

To maintain their own health and the health of their families and communities, consumers rely heavily on the health information that is available to them. This information is at the core of the partnerships that patients and their families forge with today's complex modern health systems. This information may be provided in a variety of forms â€" ranging from a discussion between a patient and a health care provider to a health promotion advertisement, a consent form, or one of many other forms of health communication common in our society. Yet millions of Americans cannot understand or act upon this information. To address this problem, the field of health literacy brings together research and practice from diverse fields including education, health services, and social and cultural sciences, and the many organizations whose actions can improve or impede health literacy. Health Literacy: Prescription to End Confusion examines the body of knowledge that applies to the field of health literacy, and recommends actions to promote a health literate society. By examining the extent of limited health literacy and the ways to improve it, we can improve the health of individuals and populations.