Increasing patient adherence to gastroenterology treatment and prevention regimens

Many gastroenterology treatments would be minimally effective if patients d id not adhere to prescribed therapeutic regimens. However, considerable evi dence exists that patients often do not adhere. Factors associated with non adherence include the physician's or other health care provider's behavior, the prescribed regimen, and the illness. These factors affect patient adhe rence such that: 1) patients do not have the skills or knowledge necessary to complete an assignment; 2) patients do not believe that they will be hel ped by the prevention or intervention activity, or they do not accept the a ctivity because they do not believe that its value will outweigh its costs; and 3) patients' environments are not supportive of, or interfere with, ad herence. Strategies that can increase adherence include attention to the ph ysician/patient relationship, direct skill training, setting up a reward st ructure, and reminders, among others. Specific methods that gastroenterolog y health care providers can utilize to enhance adherence in their practice are presented. (Am J Gastroenterol 1999;94:1733-1742. (C) 1999 by Am. Coll. of Gastroenterology).