Friday, September 01, 2006

Improving Adherence

Providing Information

Ley (1989) suggested that one way of improving compliance is to improve communication in terms of the content of an oral communication. He believes the following factors are important:

  • primacy effect - patients have a tendency to remember the first thing they are told;
  • to stress the importance of compliance;
  • to simplify the information;
  • to use repetition;
  • to be specific;
  • to follow-up the consultation with additional interviews.

Researchers also looked at the use of written information in improving compliance. Ley and Morris (1984) examined the effect of written information about medication and found that it increased knowledge in 90 per cent of the studies, increased compliance in 60 per cent of the studies, and improved outcome in 57 per cent of the studies.

Behavioural methods.

Several behavioral methods are also effective in enhancing patients' motivation to adhere to their treatment regimens (DiMatteo & DiNicola, 1982; Epstein & Cluss, 1982). These methods include:

  1. Tailoring the regimen, in which activities in the treatment are designed to be compatible with the patient's habits and rituals. For example, taking a pill at home at breakfast or while preparing for bed is easier to do and remember for most people than taking it in the middle of the day.
  2. Providing prompts and reminders, which serve as cues to perform recommended activities. These cues can include reminder phone calls for appointments or notes posted at home that remind the client to exercise. Innovative drug packaging can also help— for instance, some drugs today come in dispensers with dated compartments or built-in reminder alarms.
  3. Self-monitoring, in which the patient keeps a written record of regimen activities, such as the foods eaten each day.
  4. Contingency contracting, whereby the practitioner and client negotiate a series of treatment activities and goals in writing and specify rewards the patient will receive for succeeding.

A major advantage of these methods is that the client can become actively involved in their design and execution (Turk & Meichenbaum, 1991). Further more, the patient can carry them out alone or with the aid of the practitioner, family, or friends.

Cited in Sarafino, 1994.


Blogger jacob.rosz said...

Very good and comprehendive article, helped in my exam, thx for posting

3:20 PM  

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