Who will adhere? Key issues in the study and prediction of adherence in randomized controlled trials

Area of Science:

• Clinical Trials Methodology
• Behavioral Science in Medicine
• Health Services Research

Background:

• Adherence to treatment is crucial for the efficacy of pharmacological, dietary, and physical activity interventions.
• Existing research on adherence determinants faces theoretical and methodological challenges.
• Identifying patients at risk for non-compliance remains a significant hurdle in clinical practice.

Purpose of the Study:

• To discuss adherence determinants and key research issues in randomized controlled trials (RCTs).
• To examine adherence challenges across pharmacological, dietary, and physical activity intervention types.
• To highlight limitations hindering the identification of patients prone to poor treatment compliance.

Main Methods:

• Literature review and synthesis of existing research on adherence in RCTs.
• Discussion of theoretical frameworks and methodological approaches in adherence research.
• Analysis of challenges specific to pharmacological, dietary, and physical activity interventions.

Main Results:

• Adherence research in RCTs is hampered by theoretical and methodological limitations.
• Difficulty in identifying patients at risk for poor compliance across diverse intervention types.
• Need for improved strategies to assess and promote treatment adherence.

Conclusions:

• Enhanced theoretical models and robust methodological designs are needed for adherence research.
• Future research should focus on developing better tools to predict and manage patient non-compliance.
• Improving adherence assessment is critical for maximizing the effectiveness of clinical interventions.