Mr. Dimatteo et al., ENHANCING MEDICATION ADHERENCE THROUGH COMMUNICATION AND INFORMED COLLABORATIVE CHOICE, Health communication, 6(4), 1994, pp. 253-265
The failure of patients to adhere to medication is a significant probl
em in clinical medicine. In simple short-term acute care, as well as i
n complex longer term treatment for chronic illness, the medical presc
ription is ignored or followed incorrectly more than 40% of the time.
Recent research on adherence points to the critical role played by a p
atient's knowledge and beliefs about the benefits (vs. costs and risks
) and efficacy of adhering, as well as by his or her ability to overco
me some practical social barriers. Long-term and particularly lifetime
regimens require commitment and independent action on the part of the
patient. PREPARED(R) is a system that has recently been developed to
standardize and categorize information about benefits versus costs and
risks of treatment. In this system, providers and patients each bring
their own expertise to bear on health care decisions. Communication o
f understandable information about the benefits versus costs of medica
tion and of unambiguous details of the regimen (e.g., timing of doses)
is facilitated. Research is reviewed that stresses the importance of
a collaborative relationship between provider and patient both when th
e regimen is chosen and throughout its implementation. The role of the
PREPARED system in enhancing informed collaborative choice is discuss
ed in light of research on patient adherence to medication treatment.