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Adherence and decision AIDS: a model and a narrative review
1Department of Radiation Oncology, Department of Epidemiology, Biostatistics and HTA, Radboud University Nijmegen Medical Center, Nijmegen, The Netherlands. p.stalmeier@ebh.umcn.nl
Summary
Decision aids may improve patient adherence to treatments, but current evidence is inconclusive. Further rigorous trials are needed to confirm the benefits of decision aids in adherence research.
Area of Science:
- Health behavior research
- Shared decision-making
- Patient adherence
Background:
- Patient adherence to medication and lifestyle interventions is a significant challenge.
- Existing interventions to improve adherence yield limited positive effects.
- Decision aids are proposed as a potential strategy to enhance patient adherence.
Purpose of the Study:
- To examine the role of decision aids in adherence research.
- To develop a model organizing pathways between decision aids and adherence.
- To conduct a narrative review of existing studies on decision aids and adherence.
Main Methods:
- A model was developed to conceptualize the relationship between decision aids and adherence.
- A narrative review involved a systematic search of randomized studies.
- Eleven randomized studies were identified, with two showing positive results in hypertension management.
Main Results:
- The developed model provides a framework for studying decision aids and adherence.
- Clinical evidence supports the pathways linking decision aids to potential adherence improvements.
- The review identified shortcomings in adherence measures, sample sizes, and study designs.
Conclusions:
- A link between decision aids and adherence is theoretically plausible based on existing literature.
- Experimental evidence directly connecting decision aids and adherence remains inconclusive.
- Future rigorous trials should utilize adequate sample sizes, diverse adherence measures, and clearly outline nonadherent behavior outcomes.
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