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Matching Adherence Interventions to Patient Determinants Using the Theoretical Domains Framework.

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Improving medication adherence requires matching interventions to patient determinants. This study categorizes interventions and determinants using the Theoretical Domains Framework (TDF) to guide tailored approaches for better trial outcomes.

Keywords:
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Area of Science:

  • Pharmacology and Health Services Research
  • Behavioral Science in Medicine

Background:

  • Medication adherence interventions yield inconsistent results, often due to a lack of tailored approaches matching interventions with patient-specific non-adherence factors.
  • Existing theoretical frameworks for interventions and determinants are numerous, complicating the development of shared categories for effective matching.

Approach:

  • A pragmatic literature search identified relevant reviews on medication adherence interventions and determinants.
  • Extracted interventions and determinants were grouped into umbrella terms and categorized using the Theoretical Domains Framework (TDF).
  • Consensus discussions among authors finalized the categorization and matching process.

Key Points:

  • 103 interventions and 42 determinants (26 modifiable, 16 unmodifiable) were extracted and matched.
  • Interventions and modifiable determinants were successfully mapped across 11 TDF categories.
  • The study highlights the importance of assessing both modifiable and unmodifiable determinants for effective intervention tailoring.

Conclusions:

  • Assessing congruence between interventions and determinants is crucial for improving medication adherence trials.
  • Successful interventions must target modifiable determinants and accommodate unmodifiable ones.
  • The developed matched categories can aid in designing future adherence intervention studies and identifying patients most in need.