Understanding the problem of long-term treatment adherence: a phenomenological framework

Area of Science:

• Medical Sociology
• Phenomenology
• Health Psychology

Background:

• Chronic diseases represent a significant global health burden.
• Low long-term treatment adherence contributes to high morbidity and mortality rates worldwide.

Purpose of the Study:

• To understand the challenges of living with chronic illness and adhering to long-term treatment.
• To develop a conceptual framework for the experience of chronic disease and its impact on adherence.

Main Methods:

• Analysis of academic literature on the concept of chronicity and the experience of illness.
• Development of a phenomenological framework for understanding chronic disease experience.

Main Results:

• Distinction between a 'thin' (duration-based) and 'thick' (phenomenological) understanding of chronicity.
• A three-dimensional framework: failing to recover as a failure to belong, being at a loss, and breaking-up with oneself.
• Identified subjective states where adherence struggles appear understandable and reasonable.

Conclusions:

• A phenomenological perspective is crucial for understanding adherence challenges in chronic diseases.
• The proposed framework offers insights into ethical issues and strategies for increasing adherence.
• This approach aims to improve adherence without perpetuating disadvantage.