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Concept analysis of adherence in the context of cardiovascular risk reduction
1Asthma and Allergy Center, Roanoke, VA, USA. scohen@hawaii.edu
Insights
Understanding patient adherence is crucial for preventing cardiovascular disease. Successful adherence requires a collaborative patient-provider relationship and shared decision-making for long-term health behavior changes.
Area of Science:
- Health Psychology
- Nursing
- Medical Ethics
- Pharmacy
- Cardiology
Background:
- Cardiovascular disease is the leading cause of death in the U.S.
- Patient adherence to health recommendations is vital for disease prevention and management.
- Understanding adherence is key to patient-centered care and reducing preventable disease progression.
Purpose of the Study:
- To perform a concept analysis of adherence.
- To clarify the concept of adherence for better understanding of patient decision-making and behavior change.
- To provide a framework for improving long-term adherence to cardiovascular health recommendations.
Main Methods:
- Literature review utilizing Morse's guidelines.
- Concept analysis of adherence, concordance, and compliance.
- Examination across nursing, health psychology, ethics, pharmacy, and medicine.
Main Results:
- Adherence is a collaborative process influenced by patient beliefs, socioeconomic factors, and healthcare provider relationships.
- Key attributes of adherence include aligned behaviors, new knowledge mastery, and sustained patient-provider collaboration.
- Successful adherence involves meeting health outcome targets through active patient participation.
Conclusions:
- Adherence is defined as persistent practice of desired health behaviors through active participation and agreement.
- Developing a concordant patient-provider relationship is essential for adherence.
- Accurate measurement of adherence and prioritizing shared decision-making are critical.
Topic:
Cardiovascular disease is the number one cause of death in the United States. Examination of the concept of adherence is essential to provide informed patient-centered care to prevent the development and progression of this largely preventable disease.
Objective:
The purpose of this concept analysis is to explore and clarify the concept of adherence. This analysis will provide a framework for those seeking a better understanding of patient decision-making, reduction of relapse to unhealthy behaviors, and increased long-term adherence to cardiovascular health recommendations. Reviews of major theories related to health behavior are reviewed in the second part of the article and are linked to the concept of adherence.
Method:
Following a review of the literature, Morse's guidelines were utilized to present a concept analysis of adherence and the related terms concordance and compliance from the disciplines of nursing, health psychology, ethics, pharmacy, and medicine.
Results:
Adherence is dependent on the collaborative relationship between patient and healthcare provider. Adherence is influenced by the meaning of health, heart disease, and sense of personal risk as well as socioeconomic status, decision support, motivation, and desire for change, self-efficacy, and sources of credible health information. Attributes of successful adherence include alignment of patient behavior and health recommendations, mastery of new health knowledge and behavior, continued collaborative relationships between the patient and healthcare provider, and ability to meet outcome targets.
Conclusion:
Adherence is defined as persistence in the practice and maintenance of desired health behaviors and is the result of active participation and agreement. Adherence is dependent on the development of a concordant relationship and its measurement should be specific utilizing the correct tools. Special attention should be paid to shared decision-making between patient and healthcare provider.
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