Abstract
BackgroundAs the problem of patient non-adherence persists and a solution appears hard to be found, it continues to be important to look for new ways to further the issue. We recently conducted a meta-review of adherence intervention studies which yielded a preliminary agenda for future research, practice and theory development in patient adherence. The objective of the present project was to find out to what extent adherence experts consider this agenda relevant and feasible.MethodsThe thirty-five corresponding authors of the review studies included in the meta-review were invited to join the International Expert Forum on Patient Adherence and to participate in a four-week web-based focus group discussion. The discussion was triggered by the points on the preliminary agenda presented as propositions to which forum members could react. Two researchers analysed the transcripts and selected relevant phrases.ResultsTwenty adherence experts participated. Various ideas and viewpoints were raised. After the closure of the web-site, the expert forum was asked to authorize the synthesis of the discussion, to list the propositions in order of priority and to answer a few questions on the use of the web-based focus group as a tool to obtain expert opinions. Their ranking showed that the development of simple interventions is the most promising step to take in fostering patient adherence, preferably within a multidisciplinary setting of medical, pharmaceutical, social and technical science and, not in the least, by incorporating patients' perspectives.ConclusionFor enhancing adherence, the development of simple interventions originating from a multidisciplinary perspective including patients' input, appears most promising. Disclosing patients' perspectives requires open communication about patients' expectations, needs and experiences in taking medication and about what might help them to become and remain adherent.
Highlights
As the problem of patient non-adherence persists and a solution appears hard to be found, it continues to be important to look for new ways to further the issue
In this position paper we present the synthesis of this discussion which was authorised by all participating experts and, subsequently, their priority assignments
Internet forum discussion The experts were approached by means of a focus group discussion triggered by the six propositions which resulted from the meta-review
Summary
As the problem of patient non-adherence persists and a solution appears hard to be found, it continues to be important to look for new ways to further the issue. Not taking medication as prescribed – taking either too little, or too much, for too short, or too long a period, at the wrong time or in an ineffective way – can have negative consequences for patients, healthcare and economy [1] This non-adherence problem grows even more important as the burden of chronic diseases is growing worldwide [1]. There are effective adherence interventions, e.g. technical solutions, without an explicit theoretical explanation of the operating mechanisms; effective adherence interventions, e.g. incentives and reminders, which clearly originate from behavioral theories; theories which seem plausible for explaining but less powerful in improving adherence behavior; and a scarcity of comparative studies explicitly contrasting theoretical models or their components These conclusions were summarized in six propositions reflecting a potential research agenda for future directions in research and theory development in patient adherence. The participants were asked to complete some questions about their experiences with the web-based discussion tool
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