Gastroenterology

The COM-B framework and its use in explaining non-adherence

A comprehensive framework for the assessment of adherence is needed Non-adherence is multi-faceted. Systematic reviews have suggested many reasons why patients may not adhere to their treatments.1 Some of these may be modifiable, such as patient understanding of their condition and the support available to them, and others may be fixed (such as the age…

Gastroenterology

Patient Support Programs: personalized digital adherence support

What are PSPs? Patient Support Programs are specifically designed to help patients in understanding their condition and taking medications directly. They can range from simple interventions such as the provision of pill boxes, to more complex solutions, for example organized programs with their roots in behavioral science theory.1,2 Whereas healthcare professionals may only have time-limited…

Gastroenterology

Tools for the assessment of adherence

Quantitative methods can be used to characterize health behavior Measures and survey tools are useful mechanisms to gain an understanding of health behavior, thereby providing effective support to patients in managing their own conditions. Surveys and questionnaires are simple to implement at the point of care and acceptable to patients. Outputs can then be used…

Gastroenterology

Behavioral approaches to changing adherence

Key Messages Commonly used behavior-change strategies Commonly used behavioral change techniques may not always be the most effective methods  of changing behavior.1 For example, presenting threatening information may not have the desired effect on behavior. In the context of adherence, the evidence that simply telling a patient that they must take their medication (i.e. only…

Gastroenterology

The role of beliefs in non-adherence

Beliefs have a strong influence over non-adherent behavior Adherence to medication can be influenced by a number of important beliefs that the patient holds, including their perception of their illness, their treatment, and self-efficacy (their own capacity to adhere).1 In the long term, adherence to medication requires individuals to initiate behavior based on:2 The Health…

Gastroenterology

Understanding the challenge of adherence in pancreatic exocrine insufficiency

Pancreatic exocrine insufficiency is associated with several conditions Pancreatic exocrine insufficiency (PEI) is defined by insufficient secretion or function of pancreatic enzymes or sodium bicarbonate for normal digestion.1,2 Its prevalence in the general population is unclear, and estimations are problematic due to the lack of a suitable screening test.1 It is, however, accepted that prevalence…

Gastroenterology