Predictors of Non-Adherence

From the literature…(NEJM 353:5 August 4, 2005, page 491) with my comments about how to address them.

• Predictor: Presence of psychological problems, particularly depression
  • Study: vanServelien et al., Ammassari et al., Stilley et al.
• Predictor: Presence of cognitive impairment
  • Study: Stilley et al., Kino et al.
• Predictor: Treatment of asymptomatic disease  [Need aggressive reminder system to initial create habit]
  • Study: Sewitch et al.
• Predictor: Inadequate follow-up or discharge planning.  [Educational follow-up]
  • Study: Sewitch et al., Lacro et al.
• Predictor: Side effects of medication  [MD or RPh education of patient]
  • Study: van Servellen et al.
• Predictor: Patient’s lack of belief in benefit of treatment
  • Study: Okuno et al., Lacro et al.
• Predictor: Patient’s lack of insight into the illness  [New to therapy educational content]
  • Study: Lacro et al., Perkins
• Predictor: Poor provider-patient relationship  [Tips to patients on how to interact with MD]
  • Study: Okuno et al., Lacro et al.
• Predictor: Presence of barriers to care or medications  [Barrier survey and personalized info to address barriers]
  • Study: van Servellen et al., Perkins
• Predictor: Missed appointments  [Appointment reminders]
  • Study: Servellen et al., Farley et al.
• Predictor: Complexity of treatment  [MTM type services]
  • Study: Ammassari et al
• Predictor: Cost of medication, copayment, or both  [Value based plan design]
  • Study: Balkrishnan, Ellis et al.