Improving Patient Treatment Adherence: A Clinician's Guide

Description

Despite its direct effect on a patient’s health, the literature on treatment adherence does not yet include a summary of proven methods for identifying and addressing patient non-adherence. Improving Patient Treatment Adherence Across Multiple Behaviors: A Clinician's Guide differs significantly from many treatment adherence books on the market by focusing on clinicians and the practical tactics they need to improve patient adherence. The book is orgnaized by behavior and special issues as opposed to other texts, which look at treatment adherence as a theoretical concept. Each chapter provides a summary of existing literature regarding the impact of patient non-adherence, including costs, clinical outcomes and health-related quality of life, as well as a review of patient factors related to treatment adherence across behaviors, diseases, and special populations. A discussion of methods for improving treatment adherence takes a look at both proven methods and new technological advances in the field. Each chapter includes a table listing 3-5 key bullets that a clinician could use to address treatment adherence. Actual questions and scoring algorithms for widely used measures of treatment adherence make this book a useful guide for practicing clinicans. Contents Contributors 1 Introduction Defining Treatment Adherence Clinical Measurement of Medical Regimen Adherence Take Home Messages of the Book Conclusions References 2 Physical Activity and Adherence Adherence to Physical Activity Physical Activity Guidelines and Recommendations The Problem of Non-adherence to Physical Activity Recommendations Risk Factors for Non-adherence to Physical Activity Recommendations Demographic Factors Health-Related and Clinical Factors Cognitive and Psychological Factors Behavioral Factors Social Factors Program-Related Factors Environmental Factors Screening for Non-adherence to Physical Activity Recommendations Physical Activity Adherence Intervention Studies Public Health, Environmental, and Policy Interventions Individual Interventions Settings for Delivery of Individual Interventions Physical Activity Adherence Interventions in Special Populations Older Adults Ethnic and Racial Minorities Individuals with Low Socioeconomic Status Women Clinical and Policy Implications Summary References 3 Improving Dietary Adherence Introduction Weight Loss Initiation Versus Maintenance Barriers to and Facilitators of Diet Adherence Barriers to Diet Adherence Educational Barriers Internal Barriers External Barriers Facilitators of Diet Adherence Intervention-Related Factors Behavioral Factors Social Support Autonomy Diet Composition Assessing Dietary Intake Food Records Twenty-Four-Hour Diet Recall Food Frequency Questionnaire Other Methods Conclusion References 4 Medication Adherence Cost of Medication Non-adherence Ways to Measure Medication Adherence Predictors of Medication Non-adherence Patient Factors Clinician Factors Health-Care Factors Environmental Factors Review of Successful Interventions to Improve Medication Adherence Methods for Improving Medication Adherence Education and Behavioral Programs Dosing Schedules Patient--Provider Communication Organizational Issues Conclusion References 5 Smoking Cessation and Adherence Introduction Statement of the Problem Interventions Examples of Methods Used in Successful Programs Physician Recommendation Generic Self-Help Guides Self-Help Interventions with Tailoring Telephone Counseling Nicotine Replacement Therapy (NRT) Examples of Novel Intervention Methods Family Support Interventions Internet Interventions Telephone Quitlines Clinical and Research Implications Summary References 6 Cancer Screening Adherence Burden of Colorectal Cancer and Use of Screening Tests Risk Factors for Screening Non-adherence Factors Associated with Mammography Adherence Factors Associated with Colorectal Cancer Screening Adherence Behavioral Adherence Interventions Patient-Directed Communication Strategies Patient-Directed Access-Enhancing Strategies Provider-Directed Strategies Other Intervention Strategies Future Directions and New Technological Advances Clinical Implications of Cancer Screening Conclusions References 7 Hormonal Contraceptives and Adherence Introduction Interventions Pregnancy/Postpartum Adolescents Adolescents with Chronic Medical Conditions Obesity Policy Implications Summary References 8 Chronic Pain and Adherence Adherence to Pain Medication Underuse Overuse Abuse Monitoring Pain Medication Adherence Self-Report Questionnaires Interview-Based Methods Toxicological Screening Prescription Drug Monitoring Programs Strategies for Improving Medication Adherence Pain Medication Instructions Collaborative Treatment Planning Pain Education Programs Communication Skills Training Medication Contracts Substance Abuse Management Case Examples Summary and Future Directions References 9 Adherence and Psychotherapy Premature Termination Prevalence of Premature Termination Predictors of Premature Termination Patient Characteristics Therapist Characteristics Patient Expectations, Beliefs, and Satisfaction Treatment Alliance Therapist--Patient In-Session Interactions Significance of Premature Termination Between-Session Tasks and Exercises Prevalence and Moderators of Homework Adherence Patient Characteristics Patient Expectancies Therapist Characteristics Chicken Versus Egg Interventions Orientation Strategies to Enhance Adherence Pretherapy Preparation Motivational Enhancement Planned Termination Additional Considerations Strategies to Reduce Premature Termination Initial Session Attendance and Prompts Case Management Foster Open Dialogue Strategies to Enhance Homework Adherence Framing Homework Assignments Structuring Assignments Summary General Strategies to Enhance Adherence Strategies to Enhance Session Attendance Strategies to Enhance Homework Adherence References 10 Adherence to Treatment for Depression Factors Related to Adherence to Antidepressant Treatment Demographic Factors Psychological/Attitudinal Factors Clinical Factors Case Report: Non-adherence Clinician/Patient Communication Therapeutic Alliance Interventions That Improve Adherence Strategies That Focus on the Clinician--Patient Interaction Models of Care Case Report: Adherence Psychoeducation Practice Guidelines Use of the Internet Summary References 11 Adherence in the Treatment of HIV and Other Infectious Diseases Prevalence of Non-adherence to ART Medication Barriers to Adherence HIV Treatment ART Medication Adherence Assessment Methods of ART Adherence Promotion Future Directions and New Technological Advances Clinical and Policy Implications Other Infectious Diseases Tuberculosis Bacterial Infections Summary References 12 Adherence and Substance Use Problem Overview Treatment Adherence Prevalence of Non-adherence Consequences of Non-adherence Predictors of Good and Poor Adherence Interventions to Improve Adherence Identifying Non-adherence Improving Adherence Summary and Conclusions Appendix. Alcohol Use Disorders Identification Test Consumption (AUDIT-C) References 13 Special Considerations of Medication Adherence in Childhood and Adolescence Introduction Over-the-Counter Medications Asthma Attention Deficit Hyperactivity Disorder (ADHD) Type 1 Diabetes Mellitus (T1DM) Summary References 14 Special Considerations of Adherence in OlderAdults Barriers and Challenges Physiological Barriers to Adherence Complexity of Regimen Low Health Literacy High Costs Interventions Review of Screening Methods Review of General Medication Adherence Improvement Strategies New Technologies and Advances in Health-Care Delivery Clinical Implications Screening for Adherence Addressing Barriers and Challenges Reducing Complexity of Regimen Managing Costs Summary and Recommendations for Clinicians References Index