To support healthcare professionals in improving adherence, a series of articles has been developped to provide digestible learning resources around the role behavior science plays in adherence, including practical insights relating to therapy areas. The articles provide a useful companion to a series of masterclasses where the subjects of adherence and behavioral science are explored in more depth.
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…
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…
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…
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…
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…
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…
Cardiovascular diseases have a social and economic impact Cardiovascular disease is the leading cause of mortality globally, accounting for 17.9 million deaths a year,1 with around 75-80% of these deaths taking place in low- and middle-income countries.2 For example, in Russia, cardiovascular disease is the leading cause of death in men aged 49 or older.3…
Key Messages Defining adherence Adherence is a key factor in the effectiveness of therapies for both chronic and acute diseases. This is particularly true for cardiovascular disease, where nonadherence to chronic medications can have a negative impact on both the patient and the healthcare system. Non- adherence is often dubbed the Achilles heel of evidence-based…
Beliefs have a strong influence over a patient’s motivation to adhere to treatment These include patient beliefs about their illness, their treatment and their own capacity for adhering (self-efficacy) It is vital that clinicians assess patients individually to understand their beliefs and motivations, supporting them in adhering to their medication regimens Beliefs have an important…
Measures and survey tools are useful for characterizing patient health behavior Quantitative methods are useful for characterizing health behavior and supporting patients in the self-management of their conditions. Surveys and questionnaires have the advantages of being easy to implement at the point of care and being acceptable to patients.1 They provide explicit examples and information…
Effectiveness of commonly used behavior-change strategies Commonly used strategies to influence behavior may work in some settings, but are often the least effective in actually instigating change, such as presenting threatening information.1 In the context of adherence, this might mean simply telling a patient to take a medication and expecting them to do it –…
PSPs are behavioral interventions for improving adherence Patient Support Programs, or PSPs, can range from simple calendar pill boxes or pill blister packaging, to organized programs based on behavioral science frameworks.1,2 They can either be provided directly by the physician’s office or via sponsored programs. They are designed to support patients in being comfortable with…
There is a need for a comprehensive framework for assessing adherence Systematic reviews of non-adherence indicate that there are a myriad of reasons why patients may not adhere to their treatment regimens.1 These include both modifiable reasons that can be targeted for change, such as patient knowledge and understanding of their disease, the support available…
Patient Support Programs are designed to boost adherence Patient Support Programs (PSPs) employ a variety of techniques to help patients follow their treatment and deal with their conditions.1 Some are purely informative and provide practical information to patients on topics such as disease management and drug management (especially for complex drugs), etc. The channels through…
Non-adherence is a major issue that can be addressed by PSPs Non-adherence impedes patients from benefiting from the clinical promise of their treatment. Medications that have proven their potential in clinical trials may not deliver on that potential in the real world, potentially because of non-adherence.1 The numbers speak for themselves: average adherence rates for…
Patient Support Programs are behavioral interventions for improving adherence Non-adherence to therapies in neurological conditions is a significant issue, associated with worse clinical outcomes and increased healthcare utilization and costs.1 There are many factors involved, including complexity of medication regimens, depression, gender, and duration of disease that may lead to a patient being non-adherent,2,3 therefore,…
As described in the previous articles, adherence to treatment of patients suffering from neurological conditions can be a big issue; for Parkinson’s disease, sub-optimal adherence is estimated to vary between 10 and 67%,1 and up to half of patients with conditions such as epilepsy and bipolar disorder are estimated to be non-adherent to medication.2,3 Low…
Measures and survey tools are useful for characterizing patient health behavior Chronic diseases are a global public health issue and are increasing in prevalence and associated costs. These conditions require significant self-management by patients, including adherence to therapy regimens and medication.1 Adherence to epilepsy medication is associated with improved control of symptoms; however, non-adherence is…
Improving patient outcomes and adherence requires an actionable framework Previous articles in this series demonstrate that non-adherence is a significant public health issue in patients with neurologic disease. A study conducted in Europe in 2004 estimated that the annual economic cost of neurological disease (including dementia, epilepsy, migraine and other headaches, multiple sclerosis, Parkinson’s disease…
The Transtheoretical Model: a tool for influencing positive behavioral change Neurological disorders are a significant public health issue worldwide.1 Non-adherence to therapy for these conditions results in poor response to therapy, impacts on the quality of life of patients and causes associated costs to them and healthcare systems.2,3 Non-adherence rates have been shown to be…