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How is Patient Adherence Possible? A Novel Mechanistic Model of Adherence Based on Humanities
1Education and Health Promotion Laboratory, Sorbonne Paris Nord University, Bobigny, Île-de-France, 93000, France.
Patient Preference and Adherence
|July 24, 2023
Summary
Patient non-adherence is common, as adherence requires effort. This study proposes a model where adherence becomes easier through habit, character, and good patient-provider interaction, identifying "healthy adherers".
Area of Science:
- Behavioral Economics
- Philosophy of Mind
- Medical Humanities
Background:
- Patient non-adherence is a significant healthcare challenge, leading to increased morbidity, mortality, and costs.
- Long-term adherence to treatment in chronic diseases demands continuous patient effort, making non-adherence the default state.
Purpose of the Study:
- To propose a mechanistic model of patient adherence.
- To explain the psychological mechanisms underlying adherence by focusing on adherent patients.
- To identify factors that facilitate sustained adherence in chronic disease management.
Main Methods:
- Analysis of concepts from humanities, philosophy of mind, and behavioral economics.
- Examination of empirical studies supporting adherence hypotheses.
- Focus on the characteristics and behaviors of adherent patients.
Main Results:
- Adherence is linked to temporality and character traits.
- Habit formation is crucial for making adherence non-intentional and reducing cognitive load.
- Quality of the patient-health professional interaction significantly impacts adherence.
Conclusions:
- Adherence can be viewed as a syndrome, characterized by the
- healthy adherer phenotype,
- which distinguishes individuals at risk of non-adherence from those who are not.
- The model has implications for patient education and shared medical decision-making in managing chronic diseases like diabetes.
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