3.2 Adherence to medical advice

3.2.1 Types of non-adherence and reasons why patients do not adhere.

• types of non-adherence (failure to follow treatments and failure to attend appointments) and problems caused by non-adherence.
• explanations of why patients do not adhere:.
• rational non-adherence, including a study, e.g. Laba et al. (2012).
• Health Belief Model.

This matters because —non-adherence types and reasons determines what can be inferred or chosen; begin with the stated conditions and keep the conclusion tied to the evidence.

Example: apply —non-adherence types and reasons to one small, clearly defined case, show the key step or comparison, and explain the result in words.

Boundary: —Non-adherence types and reasons is not a universal recommendation. Check the syllabus scope, assumptions, units and the limits of the evidence before generalising.

3.2.2 Measuring non-adherence.

• subjective measures including clinical interviews and semi-structured interviews, including a study, e.g. Riekert and Drotar (1999).
• objective measures focusing on pill counting and medication dispensers, including a study, e.g. Chung and Naya (2000).
• biological measures including blood and urine samples.
• Relevant issues and debates and methodology for this topic include: application to everyday life, idiographic versus nomothetic, quantitative and qualitative data, validity, reliability.

This matters because —measuring non-adherence determines what can be inferred or chosen; begin with the stated conditions and keep the conclusion tied to the evidence.

Example: apply —measuring non-adherence to one small, clearly defined case, show the key step or comparison, and explain the result in words.

Boundary: —Measuring non-adherence is not a universal recommendation. Check the syllabus scope, assumptions, units and the limits of the evidence before generalising.

3.2.3 Improving adherence.

• improving adherence in children including a study, e.g. Chaney et al. (2004).
• individual behavioural techniques: contracts, prompts, customising treatment.
• community interventions (exemplified by the following key study).
• Key study on improving medical adherence using community interventions: Yokley and Glenwick (1984).

This matters because —improving adherence determines what can be inferred or chosen; begin with the stated conditions and keep the conclusion tied to the evidence.

Example: apply —improving adherence to one small, clearly defined case, show the key step or comparison, and explain the result in words.

Boundary: —Improving adherence is not a universal recommendation. Check the syllabus scope, assumptions, units and the limits of the evidence before generalising.