TY - JOUR
T1 - Reconceptualizing medication adherence
T2 - Six phases of dynamic adherence
AU - Gearing, Robin E.
AU - Townsend, Lisa
AU - MacKenzie, Michael
AU - Charach, Alice
PY - 2011/7/1
Y1 - 2011/7/1
N2 - Nonadherence is the Achilles' heel of effective psychiatric treatment. It affects the resolution of mental health symptoms and interferes with the assessment of treatment response. The meaning of the term adherence has evolved over time and is now associated with a variety of definitions and measurement methods. The result has been a poorly operationalized and nonstandardized term that is often interpreted differently by providers and patients. Drawing extensively from the literature, this article aims to (1) describe changes in the concept of adherence, drawing from the mental health treatment literature, (2) present a more comprehensive definition of adherence that recognizes the role of patient-provider transactions, (3) introduce dynamic adherence, a six-phase model, which incorporates the role of transactional processes and other factors that influence patients adherence decisions, and (4) provide recommendations for providers to improve adherence as well as their relationships with patients.
AB - Nonadherence is the Achilles' heel of effective psychiatric treatment. It affects the resolution of mental health symptoms and interferes with the assessment of treatment response. The meaning of the term adherence has evolved over time and is now associated with a variety of definitions and measurement methods. The result has been a poorly operationalized and nonstandardized term that is often interpreted differently by providers and patients. Drawing extensively from the literature, this article aims to (1) describe changes in the concept of adherence, drawing from the mental health treatment literature, (2) present a more comprehensive definition of adherence that recognizes the role of patient-provider transactions, (3) introduce dynamic adherence, a six-phase model, which incorporates the role of transactional processes and other factors that influence patients adherence decisions, and (4) provide recommendations for providers to improve adherence as well as their relationships with patients.
KW - Medication adherence
KW - Mental illness
KW - Patient-provider relationship
KW - Treatment compliance
UR - http://www.scopus.com/inward/record.url?scp=79960970361&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=79960970361&partnerID=8YFLogxK
U2 - 10.3109/10673229.2011.602560
DO - 10.3109/10673229.2011.602560
M3 - Review article
C2 - 21790266
AN - SCOPUS:79960970361
SN - 1067-3229
VL - 19
SP - 177
EP - 189
JO - Harvard review of psychiatry
JF - Harvard review of psychiatry
IS - 4
ER -