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Reconceptualizing medication adherence: six phases of dynamic adherence
Robin E Gearing1, Lisa Townsend, Michael MacKenzie
1Columbia University School of Social Work, New York, NY 10027, USA.
Harvard Review of Psychiatry
|July 28, 2011
Summary
Patient adherence is crucial for psychiatric treatment success. This article redefines adherence to include patient-provider interactions and introduces a dynamic model to improve treatment outcomes.
Area of Science:
- Psychiatry
- Mental Health Treatment
- Patient Adherence Research
Background:
- Nonadherence significantly hinders effective psychiatric treatment and symptom resolution.
- The concept of adherence lacks standardized definitions and operationalization, leading to varied interpretations by patients and providers.
- Existing definitions of adherence do not fully capture the complexity of patient-provider interactions.
Purpose of the Study:
- To trace the evolution of the concept of adherence in mental health treatment literature.
- To propose a comprehensive definition of adherence that emphasizes patient-provider transactions.
- To introduce a novel six-phase model of dynamic adherence and provide actionable recommendations for providers.
Main Methods:
- Extensive literature review on adherence in mental health treatment.
- Conceptual analysis of adherence definitions and measurement methods.
- Development of a new theoretical model (dynamic adherence) based on transactional processes.
Main Results:
- The concept of adherence has evolved, but remains poorly operationalized and nonstandardized.
- A new definition of adherence is proposed, integrating patient-provider transactional roles.
- A six-phase dynamic adherence model is introduced, accounting for factors influencing patient decisions.
Conclusions:
- Revising the definition and conceptualization of adherence is essential for effective psychiatric care.
- The dynamic adherence model offers a framework for understanding and improving patient adherence.
- Providers can enhance adherence and patient relationships through improved transactional processes.
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